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

Giant axonal neuropathy

Reviewed October 2007

What is giant axonal neuropathy?

Giant axonal neuropathy is an inherited condition involving dysfunction of a specific type of protein in nerve cells (neurons). The protein is essential for normal nerve function because it forms neurofilaments. Neurofilaments make up a structural framework that helps to define the shape and size of the neurons. This condition is characterized by abnormally large and dysfunctional axons, which are the specialized extensions of nerve cells that are required for the transmission of nerve impulses.

Giant axonal neuropathy generally appears in infancy or early childhood. It progresses slowly as neuronal injury becomes more severe. Signs of giant axonal neuropathy usually begin in the peripheral nervous system, which governs movement and sensation in the arms, legs, and other parts of the body. Most individuals with this disorder first have problems with walking. Later they may lose sensation, coordination, strength, and reflexes in their limbs. Hearing and visual problems may also occur. Extremely kinky hair (as compared to others in the family) is characteristic of giant axonal neuropathy, occurring in almost all affected people.

As the disorder progresses, the brain and spinal cord (central nervous system) may become involved, causing a gradual decline in mental function, loss of control of body movement, and seizures.

How common is giant axonal neuropathy?

Giant axonal neuropathy is a very rare disorder; the incidence is unknown.

What genes are related to giant axonal neuropathy?

Giant axonal neuropathy is caused by mutations in the GAN gene, which provides instructions for making a protein called gigaxonin. Some GAN gene mutations change the shape of the protein, affecting how it binds to other proteins to form a functional complex. Other mutations prevent cells from producing any gigaxonin protein.

Gigaxonin is involved in a cellular function that destroys and gets rid of excess or damaged proteins using a mechanism called the ubiquitin-proteasome system. Neurons without functional gigaxonin accumulate excess neurofilaments in the axon, causing the axons to become distended. These giant axons do not transmit signals properly and eventually deteriorate, resulting in problems with movement and other nervous system dysfunction.

Related Gene(s)

Changes in this gene are associated with giant axonal neuropathy.

  • GAN

How do people inherit giant axonal neuropathy?

This condition is 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.

Where can I find information about diagnosis or management of giant axonal neuropathy?

These resources address the diagnosis or management of giant axonal neuropathy and may include treatment providers.

  • Gene Review: Giant Axonal Neuropathy (
  • Genetic Testing Registry: Giant axonal neuropathy (

You might also find information on the diagnosis or management of giant axonal neuropathy 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 giant axonal neuropathy?

You may find the following resources about giant axonal neuropathy 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 giant axonal neuropathy?

  • GAN
  • neuropathy, giant axonal

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 giant axonal neuropathy?

Ask the Genetic and Rare Diseases Information Center (

What glossary definitions help with understanding giant axonal neuropathy?

autosomal ; autosomal recessive ; axons ; cell ; central nervous system ; distended ; gene ; incidence ; inherited ; injury ; nervous system ; neuropathy ; peripheral ; peripheral nervous system ; proteasome ; protein ; recessive ; ubiquitin

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


  • Alkan A, Kutlu R, Sigirci A, Baysal T, Altinok T, Yakinci C. Giant axonal neuropathy: MRS findings. J Neuroimaging. 2003 Oct;13(4):371-5. (
  • Allen E, Ding J, Wang W, Pramanik S, Chou J, Yau V, Yang Y. Gigaxonin-controlled degradation of MAP1B light chain is critical to neuronal survival. Nature. 2005 Nov 10;438(7065):224-8. Epub 2005 Oct 16. (
  • Bomont P, Cavalier L, Blondeau F, Ben Hamida C, Belal S, Tazir M, Demir E, Topaloglu H, Korinthenberg R, Tüysüz B, Landrieu P, Hentati F, Koenig M. The gene encoding gigaxonin, a new member of the cytoskeletal BTB/kelch repeat family, is mutated in giant axonal neuropathy. Nat Genet. 2000 Nov;26(3):370-4. (
  • Brockmann K, Pouwels PJ, Dechent P, Flanigan KM, Frahm J, Hanefeld F. Cerebral proton magnetic resonance spectroscopy of a patient with giant axonal neuropathy. Brain Dev. 2003 Jan;25(1):45-50. (
  • Bruno C, Bertini E, Federico A, Tonoli E, Lispi ML, Cassandrini D, Pedemonte M, Santorelli FM, Filocamo M, Dotti MT, Schenone A, Malandrini A, Minetti C. Clinical and molecular findings in patients with giant axonal neuropathy (GAN). Neurology. 2004 Jan 13;62(1):13-6. (
  • Ding J, Allen E, Wang W, Valle A, Wu C, Nardine T, Cui B, Yi J, Taylor A, Jeon NL, Chu S, So Y, Vogel H, Tolwani R, Mobley W, Yang Y. Gene targeting of GAN in mouse causes a toxic accumulation of microtubule-associated protein 8 and impaired retrograde axonal transport. Hum Mol Genet. 2006 May 1;15(9):1451-63. Epub 2006 Mar 24. (
  • Kuhlenbäumer G, Young P, Oberwittler C, Hünermund G, Schirmacher A, Domschke K, Ringelstein B, Stögbauer F. Giant axonal neuropathy (GAN): case report and two novel mutations in the gigaxonin gene. Neurology. 2002 Apr 23;58(8):1273-6. Erratum in: Neurology 2002 May 14;58(9):1444. (
  • Nafe R, Trollmann R, Schlote W. The giant axonal neuropathy--clinical and hisotological aspects, differential diagnosis and a new case. Clin Neuropathol. 2001 Sep-Oct;20(5):200-11. (
  • National Organization for Rare Disorders (NORD) (
  • Neuromuscular Disease Center, Washington University (
  • Wang W, Ding J, Allen E, Zhu P, Zhang L, Vogel H, Yang Y. Gigaxonin interacts with tubulin folding cofactor B and controls its degradation through the ubiquitin-proteasome pathway. Curr Biol. 2005 Nov 22;15(22):2050-5. (


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: October 2007
Published: February 8, 2016