Prenatal diagnosis of neurolipidoses.

While there is no single best procedure for performing prenatal diagnosis, ther is a rationale or strategy which will produce correct, reliable results. The investigator should be experienced with all the tests and know what to expect from each. At least two of these tests should e used (more if there s ambiguity) on amniotic fluid and cultured cell extracts. Which tests, and how many, are not as important as the skill and experience of the investigator performing them. Proper controls should be used. Probably the biggest single factor in successful prenatal diagnosis is the use of both negative and positive controls run simultaneously. No method, no matter how good or how well performed, can be counted upon to give sufficiently reproducible results to interpret without these controls. Finally, it is necessary for the investigator to be thoroughly familiar with the enzyme and its isozymes and the clinical heterogeneity of the disease. Although the foregoing details pertain specifically to Tay-Sachs disease, similar or related problems exist in the prenatal diagnosis of any of the neurolipidoses. The need for care of the samples, appreciation of biochemical and clinical heterogeneity, the need for adequate techniques, and the importance of proper controls are requirements for diagnosing any of the neurolipidoses.