ALDH18A1 and hereditary spastic paraplegia: In keeping with this, mutation carriers presented with spastic paraparesis (mild spasticity, mild weakness and brisk reflexes in the lower limbs, with no plantar response), reduced deep sensation in the lower limbs, and bladder dysfunction (with urinary frequency and urgency), that are the typical clinical features of HSP and have also been described in SPG9B families (Table 2) [13, 15].