Researchers at the All India Institute of Medical Sciences, New Delhi, India, and VU University Medical Center, Amsterdam report a 6-year-old Indian boy with infantile-onset Alexander disease having an unusually mild clinical course and a de novo mutation in the glial fibrillary acidic protein (GFAP) gene. He had a large head and delayed motor milestones since infancy. He sat at 2 years of age and walked at 3 and 1/2 years. Left focal seizures at 3 years of age were controlled by sodium valproate. Neuro exam revealed hypotonia, brisk reflexes, and extensor plantar responses. MRI showed T2 signal changes in cerebral white matter, mainly frontal. Genetic analysis confirmed the diagnosis and his condition had remained stable for 18 months.