“…However, progressive neurological symptoms with mental developmental delay and hypotonia without apparent acute episodes may also occur in a considerable number of patients [5][6][7][8][9]. Neuroradiological imaging shows, besides basal ganglia degeneration, widened Sylvian fissures, cortical atrophy with frontotemporal volume loss, delayed myelination, ventriculomegaly and subdural hemorrhages [1,5,6,8,10,11] Although the pathogenesis of the brain damage in GA I is not fully established, accumulating evidence from in vitro and in vivo experiments performed in brain tissue and cultivated neural cells from rodents and chick suggest that excitotoxicity [6,[12][13][14][15][16][17][18][19][20][21], oxidative stress [22][23][24][25][26][27][28][29][30][31] and cellular bioenergetic dysfunction [2,[32][33][34][35][36][37][38][39] are involved in the brain damage of GA I patients. It is emphasized that these studies were carried out in animal tissues with normal GCDH activity.…”