Biotin-thiamine-responsive basal ganglia disease

Biotin-thiamine-responsive basal ganglia disease (BTBGD)
Other namesBTRBGD, Biotin-responsive basal ganglia disease (BBGD), Thiamine metabolism dysfunction syndrome 2 (biotin or thiamine-responsive type) (THMD2), Thiamine-responsive encephalopathy, Thiamine transporter-2 deficiency
SpecialtyNeurometabolic disorders, neurology, internal medicine
SymptomsSubacute encephalopathy; dystonia; spasticity; seizures; dysphagia; ataxia; dysarthria; etc.
Usual onsetChildhood (ages 3–10)
DurationLifelong
CausesFamily history (inherited)
Risk factorsFebrile illness; stress; trauma
Diagnostic methodBased on symptoms, family history, brain imaging, genetic testing
Management|management= Prevention of symptoms, avoiding stressors, and routine surveillance
MedicationAdministering biotin and thiamine; symptomatic treatments

Biotin-thiamine-responsive basal ganglia disease (BTBGD) is a rare disease that affects the nervous system, particularly the basal ganglia in the brain. It is a treatable neurometabolic disorder with autosomal recessive inheritance. First described in 1998 and then genetically distinguished in 2005, the disease is characterized by progressive brain damage that, if left untreated, can lead to coma and/or death. Commonly observed in individuals with BTBGD is recurring subacute encephalopathy along with confusion, seizures, and disordered movement (hypokinesia).

BTBGD has several alternate names, including:

  • BTRBGD
  • Biotin-responsive basal ganglia disease (BBGD)
  • Thiamine metabolism dysfunction syndrome 2 (biotin or thiamine-responsive type) (THMD2)
  • Thiamine-responsive encephalopathy
  • Thiamine transporter-2 deficiency