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Living with 2-hydroxyglutaric aciduria

A group of genetic conditions that affect the brain and cause delayed development, seizures, and low muscle tone.

Understanding 2-hydroxyglutaric aciduria

2-hydroxyglutaric aciduria is a genetic condition that causes progressive damage to the brain.

There are three main types: D-2-HGA, L-2-HGA, and combined D,L-2-HGA. D-2-HGA mainly brings delayed development, seizures, and low muscle tone (hypotonia). L-2-HGA affects balance and coordination (ataxia) and can bring speech difficulties and a large head. The combined type shows up early in infancy with severe seizures, low muscle tone, and breathing and feeding problems. GARD lists onset as childhood.

Signs & symptoms

GARD doesn't list specific symptoms for this condition yet. The summary describes these features:

  • Delayed development
  • Seizures
  • Low muscle tone (hypotonia)
  • Balance and coordination problems (ataxia)
  • Speech difficulties
  • Weakened, enlarged heart (cardiomyopathy) in D-2-HGA type II

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include brain and nervous system specialists, genetic specialists and seizure and epilepsy specialists.

  3. Ask which tests can help

    Your care team will decide which exams and tests can confirm the diagnosis.

  4. Connect with expert centers

    Epilepsy Foundation may keep lists of experts for this condition.

Care & treatment

Care team
Brain and nervous system specialists (neurologists); Genetic specialists (geneticists); Seizure and epilepsy specialists (epileptologist)
Expert care
Expert lists: Epilepsy Foundation
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with Organic Acidemia Association and other patient organizations
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Which type of 2-hydroxyglutaric aciduria does my child have?
Does genetic testing show the pattern of inheritance in our family?
Should my child have heart checks and a neurology team?

Quick facts

Symptoms usually startChild
InheritanceAutosomal Dominant, Autosomal Recessive

GARD says changes in genes (also called variants) cause this condition. The subtypes differ in genetic cause and are listed as autosomal dominant or autosomal recessive.

GeneticNeurologicalInherited Metabolic

Also known as: 2-hydroxyglutaric acidemia; d2l2ad

Patient organizations

Source: NIH GARD · 2-hydroxyglutaric aciduriaGARD ID 10761 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with 2-hydroxyglutaric aciduria.

Explore the 2-hydroxyglutaric aciduria blog

Explore research for 2-hydroxyglutaric aciduria

Explore actively recruiting 2-hydroxyglutaric aciduria studies with HealthSpark.

HealthSpark

Find actively recruiting studies for 2-hydroxyglutaric aciduria with HealthSpark. Share your city to explore research near you.

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Powered by HealthSpark, our AI chat helper · Study information from ClinicalTrials.gov · Eligibility is confirmed by the study team.

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