A GABA A receptor ␣1 subunit epilepsy mutation (␣1(A322D)) introduces a negatively charged aspartate residue into the hydrophobic M3 transmembrane domain of the ␣1 subunit. We reported previously that heterologous expression of ␣1(A322D)2␥2 receptors in mammalian cells resulted in reduced total and surface ␣1 subunit protein. Here we demonstrate the mechanism of this reduction. Total ␣1(A322D) subunit protein was reduced relative to wild type protein by a similar amount when expressed alone (86 ؎ 6%) or when coexpressed with 2 and ␥2S subunits (78 ؎ 6%), indicating an expression reduction prior to subunit oligomerization. In ␣12␥2S receptors, endoglycosidase H deglycosylated only 26 ؎ 5% of ␣1 subunits, consistent with substantial protein maturation, but in ␣1(A322D)2␥2S receptors, endoglycosidase H deglycosylated 91 ؎ 4% of ␣1(A322D) subunits, consistent with failure of protein maturation. To determine the cellular localization of wild type and mutant subunits, the ␣1 subunit was tagged with yellow (␣1-YFP) or cyan (␣1-CFP) fluorescent protein. Confocal microscopic imaging demonstrated that 36 ؎ 4% of ␣1-YFP2␥2 but only 5 ؎ 1% ␣1(A322D)-YFP2␥2 colocalized with the plasma membrane, whereas the majority of the remaining receptors colocalized with the endoplasmic reticulum (55 ؎ 4% ␣1-YFP2␥2S, 86 ؎ 3% ␣1(A322D)-YFP). Heterozygous expression of ␣1-CFP2␥2S and ␣1(A322D)-YFP2␥2S or ␣1-YFP2␥2S and ␣1(A322D)-CFP2␥2S receptors showed that membrane GABA A receptors contained primarily wild type ␣1 subunits. These data demonstrate that the A322D mutation reduces ␣1 subunit expression after translation, but before assembly, resulting in endoplasmic reticulum-associated degradation and membrane ␣1 subunits that are almost exclusively wild type subunits.GABA A 2 receptors are pentameric ligand-gated chloride ion channels that are the major inhibitory neurotransmitter receptors in the mammalian central nervous system (1). The five subunits arise from seven subunit families that contain multiple subtypes and assemble in a limited number of subunit combinations, with the most prevalent consisting of two ␣1 subunits, two 2 subunits, and one ␥2 subunit (2-5). Each subunit contains four hydrophobic segments (M1-M4) that are homologous to the four membrane spanning helices of the Torpedo marmorata nicotinic acetylcholine receptor (AChR) subunits whose three-dimensional structure has been determined to 4 Å (6).A nonconserved missense mutation in the GABA A receptor ␣1 subunit gene (GABRA1, ␣1(A322D)) that codes for an aspartate in place of an alanine at position 7 of the M3 transmembrane segment is present in a form of autosomal dominant juvenile myoclonic epilepsy (7), an idiopathic generalized epilepsy syndrome that accounts for ϳ10% of all cases of epilepsy (8). When expressed in heterologous cells, this mutation affects both the function and expression of GABA A receptors. Expression of the ␣1(A322D) subunit with 2 and ␥2 subunits ("homozygous expression") reduced peak currents by ϳ90%, substantially altered whole c...