Neurodegeneration with Brain Iron Accumulation

Neurodegeneration with brain iron accumulation (NBIA) is a rare, inherited, neurological movement disorder characterized by progressive degeneration of the nervous system.

Onset of the disorder usually develops during childhood.

Symptoms, which vary greatly among patients, may include:

  • Slow writhing
  • Distorting muscle contractions of the limbs, face, or trunk
  • Choreoathetosis (involuntary, purposeless jerky muscle movements)
  • Muscle rigidity (uncontrolled tightness of the muscles)
  • Spasticity (sudden, involuntary muscle spasms)
  • Ataxia (inability to coordinate movements)
  • Confusion
  • Disorientation
  • Seizures
  • Stupor
  • Dementia

Other less common symptoms may include:

  • Painful muscle spasms
  • Dysphasia (difficulty speaking)
  • Mental retardation
  • Facial grimacing
  • Dysarthria (poorly articulated speech)
  • Visual impairment

Most patients experience periods of rapid deterioration lasting 1–2 months, with relatively stable periods in between. The rate of progression correlates with the age at onset, meaning that children with early symptoms tend to fare more poorly. For those with early onset, dystonia and spasticity can eventually limit the ability to walk, usually leading to use of a wheelchair by the midteens.

Life expectancy is variable, although premature death does occur in NBIA. Premature death usually occurs secondary to dystonia and impaired swallowing, which can lead to poor nutrition or aspiration pneumonia. With improved medical care, however, a greater number of affected individuals reach adulthood. For those with atypcial, late-onset NBIA, many are diagnosed as adults and live well into adulthood.

There is no cure for NBIA, nor is there a standard course of treatment. Treatment is symptomatic and supportive, and may include physical or occupational therapy, exercise physiology, and/or speech pathology.