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Among 24 reviewed late-onset patients with MTHFR deficiency in literature [23, 27] , all developed symptoms in adolescents/adults (the mean age of onset of neurological symptoms was 22.4-year-old, excluding mild learning disabilities reported in 29% of patients), some patients experienced a sub-acute onset of symptoms, sometimes following chronic evolution of symptoms, clinical manifestations included gait disorder (96%, from both central and peripheral etiologies), cognitive decline (74%), epileptic syndromes (50%), encephalopathy (30%), psychotic symptoms (17%), and thrombotic events (21%)

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Treatment includes oral or intravenous antibacterial drugs