National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Alpers syndrome



Other Names:
Alpers disease; Alpers diffuse degeneration of cerebral gray matter with hepatic cirrhosis; Alpers progressive infantile poliodystrophy; Alpers disease; Alpers diffuse degeneration of cerebral gray matter with hepatic cirrhosis; Alpers progressive infantile poliodystrophy; Poliodystrophia cerebri progressiva; Progressive cerebral poliodystrophy; Diffuse cerebral degeneration in infancy; Alpers-Huttenlocher syndrome; Neuronal degeneration of childhood with liver disease, progressive; PNDC; Infantile poliodystrophy See More
Categories:

Alpers syndrome is a progressive neurologic disorder that begins during childhood and is complicated in many instances by serious liver disease. Symptoms include increased muscle tone with exaggerated reflexes (spasticity), seizures, and loss of cognitive ability (dementia). [1]  Most often Alpers syndrome is caused by mutations in the POLG gene. [2]
Last updated: 1/24/2011

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms Other Names
Learn More:
HPO ID
30%-79% of people have these symptoms
Areflexia
Absent tendon reflexes
0001284
Ataxia 0001251
Bilateral tonic-clonic seizure
Grand mal seizures
0002069
Choreoathetosis 0001266
Coma 0001259
Developmental regression
Loss of developmental milestones
Mental deterioration in childhood
[ more ]
0002376
Focal-onset seizure
Seizure affecting one half of brain
0007359
Global developmental delay 0001263
Microcephaly
Abnormally small skull
Decreased circumference of cranium
Decreased size of skull
Reduced head circumference
Small head circumference
[ more ]
0000252
Muscular hypotonia
Low or weak muscle tone
0001252
Myoclonus 0001336
Progressive spasticity 0002191
Spastic paraparesis 0002313
5%-29% of people have these symptoms
Blindness 0000618
Percent of people who have these symptoms is not available through HPO
3-Methylglutaconic aciduria 0003535
Abnormality of visual evoked potentials 0000649
Astrocytosis 0002446
Autosomal recessive inheritance 0000007
Bile duct proliferation 0001408
Cerebellar atrophy
Degeneration of cerebellum
0001272
Cerebral cortical neurodegeneration 0006964
Cerebral visual impairment 0100704
Dementia
Dementia, progressive
Progressive dementia
[ more ]
0000726
Elevated hepatic transaminase
High liver enzymes
0002910
Epilepsia partialis continua 0012847
Ethylmalonic aciduria 0003219
Failure to thrive
Faltering weight
Weight faltering
[ more ]
0001508
Generalized hypotonia
Decreased muscle tone
Low muscle tone
[ more ]
0001290
Gliosis 0002171
Hepatic failure
Liver failure
0001399
Hepatomegaly
Enlarged liver
0002240
Hypertonia 0001276
Increased CSF protein 0002922
Increased serum lactate 0002151
Infantile onset
Onset in first year of life
Onset in infancy
[ more ]
0003593
Micronodular cirrhosis 0001413
Microvesicular hepatic steatosis 0001414
Neuronal loss in central nervous system
Loss of brain cells
0002529
Paralysis
Inability to move
0003470
Rapidly progressive
Worsening quickly
0003678
Status epilepticus
Repeated seizures without recovery between them
0002133
Visual loss
Loss of vision
Vision loss
[ more ]
0000572
Vomiting
Throwing up
0002013
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Last updated: 7/1/2020

Making a diagnosis for a genetic or rare disease can often be challenging. Healthcare professionals typically look at a person’s medical history, symptoms, physical exam, and laboratory test results in order to make a diagnosis. The following resources provide information relating to diagnosis and testing for this condition. If you have questions about getting a diagnosis, you should contact a healthcare professional.

Testing Resources

  • Orphanet lists international laboratories offering diagnostic testing for this condition.

Treatment for Alpers syndrome is limited to managment of symptoms and supportive care. There is currently no cure. [2] [3]
A multi-disciplinary medical team of a gastroenterologist, neurologist, occupational, physical and/or speech therapist can assist with management of symptoms to maintain function as long as possible, insure comfort and promote the best possible quality-of-life. [2]
Last updated: 5/26/2011

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources


Related diseases are conditions that have similar signs and symptoms. A health care provider may consider these conditions in the table below when making a diagnosis. Please note that the table may not include all the possible conditions related to this disease.

Conditions with similar signs and symptoms from Orphanet
Differential diagnoses are numerous with some examples being disease phenocopies caused by mutations in the C10ORF2 gene (10q24), which can cause autosomal dominant progressive external ophthalmoplegia (adPEO) as well as recessive mutations that can lead to other phenotypes that may overlap with AHS. Others disorders include infantile neuronal ceroid-lipofuscinosis, late-infantile neuronal ceroid lipofuscinosis, MERRF and MELAS. Other POLG-related disorders include recessive mitochondrial ataxia syndrome (MIRAS), ataxia neuropathy spectrum (ANS), and autosomal recessive PEO.
Visit the Orphanet disease page for more information.

Research helps us better understand diseases and can lead to advances in diagnosis and treatment. This section provides resources to help you learn about medical research and ways to get involved.

Clinical Research Resources

  • Orphanet lists European clinical trials, research studies, and patient registries enrolling people with this condition. 
  • The North American Mitochondrial Disease Consortium (NAMDC) is a team of doctors, nurses, research coordinators, and research labs throughout the U.S., working together to improve the lives of people with this condition through research.

Support and advocacy groups can help you connect with other patients and families, and they can provide valuable services. Many develop patient-centered information and are the driving force behind research for better treatments and possible cures. They can direct you to research, resources, and services. Many organizations also have experts who serve as medical advisors or provide lists of doctors/clinics. Visit the group’s website or contact them to learn about the services they offer. Inclusion on this list is not an endorsement by GARD.

Organizations Supporting this Disease


Living with a genetic or rare disease can impact the daily lives of patients and families. These resources can help families navigate various aspects of living with a rare disease.

Financial Resources


These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

Where to Start

In-Depth Information

  • GeneReviews provides current, expert-authored, peer-reviewed, full-text articles describing the application of genetic testing to the diagnosis, management, and genetic counseling of patients with specific inherited conditions.
  • The Monarch Initiative brings together data about this condition from humans and other species to help physicians and biomedical researchers. Monarch’s tools are designed to make it easier to compare the signs and symptoms (phenotypes) of different diseases and discover common features. This initiative is a collaboration between several academic institutions across the world and is funded by the National Institutes of Health. Visit the website to explore the biology of this condition.
  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • Orphanet is a European reference portal for information on rare diseases and orphan drugs. Access to this database is free of charge.
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Alpers syndrome. Click on the link to view a sample search on this topic.

Questions sent to GARD may be posted here if the information could be helpful to others. We remove all identifying information when posting a question to protect your privacy. If you do not want your question posted, please let us know. Submit a new question

  • My nephew has just been diagnosed with Alpers syndrome. The family is devastated. Is there a treatment or cure? See answer



  1. NORD. Alpers Disease. NORD: National Organization for Rare Disease. 2007; http://www.rarediseases.org/search/rdbdetail_abstract.html?disname=Alpers%20Disease. Accessed 1/20/2011.
  2. Cohen B, Chinnery P, Copeland W. POLG-Related Disorders. GeneReviews. March 16, 2010; http://www.ncbi.nlm.nih.gov/books/NBK26471/. Accessed 1/20/2011.
  3. Naviaux R K. Alpers syndrome. Orphanet. July 2006; http://www.orpha.net/consor/cgi-bin/OC_Exp.php?lng=EN&Expert=726. Accessed 1/20/2011.