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Living with Hereditary spastic paraplegia 44

A very rare, complex type of hereditary spastic paraplegia starting late, with mild balance and speech problems.

Understanding Hereditary spastic paraplegia 44

Hereditary spastic paraplegia 44 (SPG44) is a very rare, complex form of hereditary spastic paraplegia with late-onset, slowly worsening leg stiffness.

It comes with mild poor balance (ataxia) and slurred speech, trouble with finger dexterity, and mild thinking changes. People have a thin corpus callosum and a hypomyelinating leukodystrophy (too little of the protective coating on nerves in the brain) with normal or near-normal development. It starts in the teens or adulthood.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Stiff legs (spasticity)
  • Trouble walking
  • Poor balance (ataxia)
  • Speech trouble (dysarthria)
  • Hearing loss
  • Bladder problems

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 and genetic specialists.

  3. Consider genetic testing

    Changes in GJC2 are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

  4. Connect with expert centers

    Spastic Paraplegia Foundation may keep lists of experts for this condition.

Care & treatment

Care team
Brain and nervous system specialists (neurologists); Genetic specialists (geneticists)
Expert care
Expert lists: Spastic Paraplegia 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 Spastic Paraplegia Foundation
  • 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
Could genetic testing for the GJC2 gene confirm the diagnosis?
How often should hearing and vision be checked?
Which therapies help with balance and speech?

Quick facts

Symptoms usually startTeenager and as an Adult
InheritanceAutosomal Recessive
GenesGJC2

It is caused by changes in the GJC2 gene. It is autosomal recessive, so a child inherits a changed copy of the gene from each parent.

GeneticNeurological

Also known as: autosomal recessive complex spastic paraplegia caused by mutation in gjc2; autosomal recessive spastic paraplegia 44; autosomal recessive spastic paraplegia type 44; gjc2 autosomal recessive complex spastic paraplegia; hereditary spastic paraplegia type 44; spastic paraplegia 44

Patient organizations

Broader rare-disease groups

Source: NIH GARD · Hereditary spastic paraplegia 44GARD ID 17478 · 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 Hereditary spastic paraplegia 44.

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