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Features include always present findings: Decreased motor nerve conduction velocity, Motor delay, Increased endomysial connective tissue, and Lower limb muscle weakness and others; and common findings: Abolished vibration sense, Achilles tendon contracture, Distal upper limb amyotrophy, and Proximal upper limb muscle weakness and others. 23 total HPO annotations.
Organ System | Phenotype Count | Example Features |
|---|---|---|
Muscles | 8 |
SLC12A6 function has not been fully characterized.
Charcot-Marie-Tooth disease, axonal, IIa 2II is associated with mutations in the SLC12A6 gene on chromosome 15.
The data from affected individuals are insufficient to establish genotype-phenotype correlations.
Consensus diagnostic criteria for hereditary motor and sensory neuropathy with agenesis of the corpus callosum (HMSN/ACC) have not been established.
Hereditary motor and sensory neuropathy with agenesis of the corpus callosum (HMSN/ACC) should be suspected in individuals with the following clinical, electrophysiologic, and neuroimaging findings, and family history .
Clinical findings
No approved treatments are currently available for Charcot-Marie-Tooth disease, axonal, IIa 2II. The disease remains an area of unmet medical need.
Consensus clinical management recommendations for hereditary motor and sensory neuropathy with agenesis of the corpus callosum (HMSN/ACC) have not been published. Evaluations Following Initial Diagnosis To establish the extent of disease and needs in an individual diagnosed with hereditary motor and sensory neuropathy with agenesis of the corpus callosum (HMSN/ACC), the evaluations summarized (if not performed as part of the evaluation that led to the diagnosis) are recommended. Table 4. Recommended Evaluations Following Initial Diagnosis in Individuals with Hereditary Motor and Sensory Neuropathy with Agenesis of the Corpus Callosum
Table 6. Recommended Surveillance for Individuals with Hereditary Motor and Sensory Neuropathy with Agenesis of the Corpus Callosum
System/Concern |
|---|
Data assembled from 5 of 12 sources · Last updated Sep 20, 2026, 1:03 AM UTC
Online Mendelian Inheritance in Man
Common questions about Charcot-Marie-Tooth disease, axonal, IIa 2II
Arms and legs | 7 | Lower limb muscle weakness, Foot dorsiflexor weakness, Intrinsic hand muscle atrophy |
Brain and nerves | 4 | Seizure, Motor axonal neuropathy, Intellectual disability |
Lab test results | 1 | Abnormal circulating creatine kinase concentration |
Bones and joints | 1 | Sideways curvature of the spine (scoliosis) |
Hereditary motor and sensory neuropathy with agenesis of the corpus callosum (HMSN/ACC) is both a neurodevelopmental disorder (with variable degrees of dysgenesis of the corpus callosum and mild-to-severe intellectual disability) and a neurodegenerative disorder (severe progressive sensorimotor neuropathy). The neurologic findings of HMSN/ACC in 64 individuals (ages 2 to 34 years) in the French Canadian population reported by are summarized in , with additional information from , , and . Table 2. Hereditary Motor and Sensory Neuropathy with Agenesis of the Corpus Callosum: Select Features
Feature | % of Persons w/Feature | Comment |
|---|---|---|
Motor sensory neuropathy | 100% | Cranial nerve involvement |
Ptosis | 33%-59% | Symmetric or asymmetric |
Gaze palsy | 13%-30% | — |
Horizontal nystagmus | 20% | — |
Facial weakness | 34%-100% | Symmetric or asymmetric; may be assoc w/hemifacial atrophy Cognitive function |
Normal | 8% | Based on Taft clinical classification to stratify cognitive function in 53 persons1 Mild ID |
Psychotic episodes | 39% (25/64) | After age 15 yrs1 |
Scoliosis | 86% | Average onset age 10.4 yrs |
Pulmonary restrictive syndrome | Unknown | Related to scoliosis axonal loss affecting respiratory muscles2 |
Contractures | 59% | MCP joint (flexion) contracture 50% |
Seizures | 17% | Generalized, absence, or focal seizures3 |
Tremor | 25% | ID = intellectual disability; MCP = metacarpophalangeal Based on and 1. 2. 3. |
Source: GeneReviews — "Hereditary Motor and Sensory Neuropathy with Agenesis of the Corpus Callosum"
Source: GeneReviews — "Hereditary Motor and Sensory Neuropathy with Agenesis of the Corpus Callosum"
Developmental delay / intellectual disability ranging from mild to severe
Electrophysiology
Source: GeneReviews — "Hereditary Motor and Sensory Neuropathy with Agenesis of the Corpus Callosum"
Table 3.
Autosomal Recessive Neurodegenerative Disorders in the Differential Diagnosis of Hereditary Motor and Sensory Neuropathy with Agenesis of the Corpus Callosum
Gene(s) | DiffDx Disorder | Clinical Characteristics | Features Distinguishing from HMSN/ACC
EGR2
FGD4
FIG4
GDAP1
MTMR2
NDRG1
PRX
SBF1
SBF2
SH3TC2
| Autosomal recessive HMSN (previously CMT4) (See CMT Overview.) | Severe early-onset neuropathy | Absence of ID dysgenesis of CC
| Classic infantile neuroaxonal dystrophy (INAD) (See PLA2G6 Neurodegeneration.) | • Classic INAD: typical onset age 6 mos to 3 yrs w/developmental regression, hypotonia, progressive psychomotor delay, progressive spastic tetraparesis; strabismus, nystagmus, optic atrophy common; ± partial ACC
Source: GeneReviews — "Hereditary Motor and Sensory Neuropathy with Agenesis of the Corpus Callosum"
Genetic testing for SLC12A6 is available. Testing is considered confirmatory for diagnosis.
System/Concern | Evaluation | Comment |
|---|---|---|
neuropathy | Neurologic exam | Obtain EEG.; Consider MRI if not previously performed. Seizures |
Musculoskeletal | Orthopedics / physical medicine rehab / PT OT eval | To incl assessment of:; Gross motor fine motor skills; Possible contractures (esp Achilles tendon); Need for PT (to improve gross motor skills) /or OT (to improve fine motor skills); Mobility, self-help skills, ADL, need for adaptive devices |
Scoliosis | Orthopedics pulmonary medicine | Baseline eval for scoliosis; Baseline pulmonary function assessment given risk for restrictive lung disease Extraocular muscle |
involvement | Ophthalmologic exam | Assess for ptosis, esotropia or exotropia, gaze palsy, nystagmus. Developmental delay / Intellectual |
disability | Developmental assessment | To incl motor, adaptive, cognitive, speech-language eval; Eval for early intervention / special education / community social activities Psychotic |
episodes | Obtain history of possible events. | When concerns, refer for psychiatric eval. Genetic |
counseling | By genetics professionals1 | To obtain a pedigree inform affected persons their families re nature, MOI, implications of HMSN/ACC to facilitate medical personal decision making Family support resources |
Manifestation/Concern | Treatment | Considerations/Other |
Seizures | Standardized treatment w/ASM by experienced neurologist | Many ASMs may be effective; none has been demonstrated effective specifically for this disorder.; Valproate may also be beneficial for behavioral problems.; Education of parents/caregivers1 Extraocular muscle |
involvement | Standard treatment(s) per ophthalmologist | — |
Musculoskeletal | Orthopedics / physical medicine rehab / PT OT | Regular physiotherapy to maximize mobility risk for later orthopedic complications (e.g., hand foot contractures, scoliosis); Walking aids incl canes or walkers when appropriate; Durable medical equipment positioning devices as needed (e.g. |
Scoliosis | Orthopedics | Depending on degree of severity, scoliosis usually requires surgical correction. Pulmonary medicine |
Intellectual disability | See . | — |
Psychotic episodes | Psychiatric eval | Low-dose neuroleptics may be useful. Family support/ resources |
Source: GeneReviews — "Hereditary Motor and Sensory Neuropathy with Agenesis of the Corpus Callosum"
Search ClinicalTrials.gov in the US and EU Clinical Trials Register in Europe for information on clinical studies for a wide range of diseases and conditions. Note: There may not be clinical trials for this disorder.
Source: GeneReviews — "Hereditary Motor and Sensory Neuropathy with Agenesis of the Corpus Callosum"
View trials for Charcot-Marie-Tooth disease, axonal, IIa 2II
Evaluation
Frequency |
|---|
neuropathy | Neurologic exam | Annual |
Seizures | Evaluate response to current treatment. | Per treating neurologist Assess for new-onset seizures |
Musculoskeletal | Per treating PT/OT | Annual or biannual |
Scoliosis | Per treating orthopedist | Esp in early teen yrs when significant scoliosis is likely to appear; Annual or biannual Restrictive lung |
disease | Monitor for evidence of respiratory insufficiency. | As needed if symptoms are present Extraocular muscle |
involvement | Ophthalmologic exam | Per treating ophthalmologist Developmental delay / |
Intellectual disability | Monitor developmental progress educational needs. | At each visit |
Psychotic episodes | Evaluate response to current treatment. | As needed; Refer to psychiatrist. Evaluate for new-onset psychosis paranoid delusions. |
Source: GeneReviews — "Hereditary Motor and Sensory Neuropathy with Agenesis of the Corpus Callosum"
Phenotype severity distribution: 14 always present features, 6 common features.