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From the Dipartimento di Scienze Neurologiche e Psichiatriche dellEtà Evolutiva (Drs. Leuzzi and Cerquiglini), Università "La Sapienza," Rome; the Dipartimento di Neuroradiologia (Dr. Bianchi), Ospedale S. Chiara, Pisa; the Istituto Scientifico Stella Maris (Drs. Tosetti and Cioni), Pisa; and the Dipartimento di Medicina Sperimentale (Drs. Carducci and Antonozzi), Università "La Sapienza", Rome, Italy.
Address correspondence and reprint requests to Dr. V. Leuzzi, Istituto di Neuropsichiatria Infantile, Via dei Sabelli 108, 00185 Rome, Italy.
The authors describe an Italian child with guanidinoacetate methyltransferase deficiency, neurologic regression, movement disorders, and epilepsy during the first year of life. Brain MRI showed pallidal and periaqueductal alterations. In vivo 1H-MRS showed brain creatine depletion. The assessment of guanidinoacetic acid concentration in biologic fluids confirmed the diagnosis. Clinical, biochemical, and neuroradiologic improvement followed creatine supplementation.
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