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Genetics Home Reference: your guide to understanding genetic conditions     A service of the U.S. National Library of Medicine®

Brown-Vialetto-Van Laere syndrome

(often shortened to BVVLS)
Reviewed August 2012

What is BVVLS?

Brown-Vialetto-Van Laere syndrome (BVVLS) is a disorder characterized by nerve problems, particularly hearing loss caused by nerve damage in the inner ear (sensorineural hearing loss). The age at which this condition begins varies from infancy to young adulthood. When BVVLS begins in infancy, the first symptom is often breathing problems caused by nerve damage. When the condition begins in children or young adults, sensorineural hearing loss usually occurs first, followed by signs of other nerve problems.

BVVLS involves nerves found in the part of the brain that is connected to the spinal cord (the brainstem). In particular, certain nerves that are found in a region of the brainstem known as the pontobulbar region are damaged in people with this condition, causing paralysis of muscles controlled by the affected nerves. This abnormality is called pontobulbar palsy. Nerves in this region help control voluntary muscle activities such as walking, speaking, and some aspects of breathing. As a result of pontobulbar palsy, people with BVVLS can have breathing problems; slurred speech; and muscle weakness in the face, neck, shoulders, and limbs. Affected individuals can also have muscle stiffness (spasticity) and exaggerated reflexes.

The signs and symptoms of this condition worsen with age. Approximately one-third of affected individuals survive more than 10 years after the condition begins. Severe breathing problems and respiratory infections are often fatal in people with BVVLS. For unknown reasons, BVVLS occurs in approximately three times more females than males, but males seem to be more severely affected.

A condition called Fazio-Londe disease has similar signs and symptoms as BVVLS except without sensorineural hearing loss. It is unclear if Fazio-Londe disease and BVVLS are separate disorders or forms of the same condition.

How common is BVVLS?

BVVLS is a rare condition. Approximately sixty cases have been reported in the scientific literature.

What genes are related to BVVLS?

BVVLS is caused by mutations in the SLC52A3 gene (previously called the C20orf54 gene). This gene provides instructions for making the riboflavin transporter 2 (RFT2) protein, which transports a vitamin called riboflavin (or vitamin B2) across the cell membrane. Riboflavin cannot be made by the body, so it must be obtained from the food a person eats. The RFT2 protein is found at especially high levels in cells of the small intestine and is important for absorbing riboflavin from the small intestine after digestion so that the vitamin can be used in the body.

Riboflavin is the core component of molecules called flavin adenine dinucleotide (FAD) and flavin mononucleotide (FMN). These molecules function as coenzymes, which means they help enzymes carry out chemical reactions. FAD and FMN are involved in many different chemical reactions and are required for a variety of cellular processes. One important role of these coenzymes is in the production of energy for cells. FAD and FMN are also involved in the breakdown (metabolism) of carbohydrates, fats, and proteins.

Mutations in the SLC52A3 gene that cause BVVLS lead to an abnormal RFT2 protein with impaired ability to transport riboflavin. Consequently, there is a reduction of riboflavin available in the body. However, it is unclear how these changes lead to the signs and symptoms of BVVLS.

Related Gene(s)

Changes in this gene are associated with Brown-Vialetto-Van Laere syndrome.

  • SLC52A3

How do people inherit BVVLS?

About half of all cases of BVVLS are inherited in an autosomal recessive pattern, which means both copies of the gene in each cell have mutations. The parents of an individual with an autosomal recessive condition each carry one copy of the mutated gene, but they typically do not show signs and symptoms of the condition.

The other half of BVVLS cases are not inherited and occur in people with no history of the condition in their family. These cases are described as sporadic.

Where can I find information about diagnosis or management of BVVLS?

These resources address the diagnosis or management of BVVLS and may include treatment providers.

  • Genetic Testing Registry: Brown-Vialetto-Van laere syndrome (

You might also find information on the diagnosis or management of BVVLS in Educational resources and Patient support.

General information about the diagnosis ( and management ( of genetic conditions is available in the Handbook. Read more about genetic testing (, particularly the difference between clinical tests and research tests (

To locate a healthcare provider, see How can I find a genetics professional in my area? ( in the Handbook.

Where can I find additional information about BVVLS?

You may find the following resources about BVVLS helpful. These materials are written for the general public.

You may also be interested in these resources, which are designed for healthcare professionals and researchers.

What other names do people use for BVVLS?

  • pontobulbar palsy with deafness
  • progressive bulbar palsy with sensorineural deafness

For more information about naming genetic conditions, see the Genetics Home Reference Condition Naming Guidelines ( and How are genetic conditions and genes named? ( in the Handbook.

What if I still have specific questions about BVVLS?

Ask the Genetic and Rare Diseases Information Center (

What glossary definitions help with understanding BVVLS?

adenine ; autosomal ; autosomal recessive ; brainstem ; breakdown ; cell ; cell membrane ; digestion ; gene ; inherited ; intestine ; metabolism ; palsy ; protein ; recessive ; respiratory ; sensorineural ; sensorineural hearing loss ; spasticity ; sporadic ; symptom ; syndrome ; voluntary muscle

You may find definitions for these and many other terms in the Genetics Home Reference Glossary.


  • Bosch AM, Abeling NG, Ijlst L, Knoester H, van der Pol WL, Stroomer AE, Wanders RJ, Visser G, Wijburg FA, Duran M, Waterham HR. Brown-Vialetto-Van Laere and Fazio Londe syndrome is associated with a riboflavin transporter defect mimicking mild MADD: a new inborn error of metabolism with potential treatment. J Inherit Metab Dis. 2011 Feb;34(1):159-64. doi: 10.1007/s10545-010-9242-z. Epub 2010 Nov 26. (
  • Dipti S, Childs AM, Livingston JH, Aggarwal AK, Miller M, Williams C, Crow YJ. Brown-Vialetto-Van Laere syndrome; variability in age at onset and disease progression highlighting the phenotypic overlap with Fazio-Londe disease. Brain Dev. 2005 Sep;27(6):443-6. Epub 2004 Dec 15. (
  • Green P, Wiseman M, Crow YJ, Houlden H, Riphagen S, Lin JP, Raymond FL, Childs AM, Sheridan E, Edwards S, Josifova DJ. Brown-Vialetto-Van Laere syndrome, a ponto-bulbar palsy with deafness, is caused by mutations in c20orf54. Am J Hum Genet. 2010 Mar 12;86(3):485-9. doi: 10.1016/j.ajhg.2010.02.006. Epub 2010 Mar 4. (
  • Nabokina SM, Subramanian VS, Said HM. Effect of clinical mutations on functionality of the human riboflavin transporter-2 (hRFT-2). Mol Genet Metab. 2012 Apr;105(4):652-7. doi: 10.1016/j.ymgme.2011.12.021. Epub 2012 Jan 5. (
  • Oregon State University Linus Pauling Institute: Riboflavin (
  • Sathasivam S. Brown-Vialetto-Van Laere syndrome. Orphanet J Rare Dis. 2008 Apr 17;3:9. doi: 10.1186/1750-1172-3-9. Review. (


The resources on this site should not be used as a substitute for professional medical care or advice. Users seeking information about a personal genetic disease, syndrome, or condition should consult with a qualified healthcare professional. See How can I find a genetics professional in my area? ( in the Handbook.

Reviewed: August 2012
Published: November 23, 2015