FA2H and cerebellar ataxia: For example, autosomal recessive mutations in fatty acid 2-hydroxylase (FA2H), which catalyzes the hydroxylation of ceramide at position 2 of the N-acyl chain, result in HSP type 35, which is characterized by early-onset progressive spasticity, ataxia, dystonia and cognitive decline (Edvardson et al., 2008).