Presentation
A hairless, purplish-red patch is usually present in the occipital-parietal region during infancy but becomes smaller as children grow. No encephalocele is present. Hearing loss and heart defects have not been reported. Intelligence is normal. [disorders.eyes.arizona.edu]
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Clinical presentation Most individuals with Joubert syndrome present with hypotonia, or decreased muscle tone, in infancy, which progresses to ataxia, which is a lack of muscle control during voluntary movements, in early childhood. [news-medical.net]
We present a case of a 7-year-old female patient who has been under treatment since she was 1 year old. [jclpca.org]
Oscillopsia or blurred vision while reading, in lateral gaze, or with head motion can be a presenting complaint (1012,1013). [neuroophthalmology.ca]
Entire Body System
- Dentist
The book will appeal to clinical geneticists, pediatricians, neurologists, head and neck surgeons, otolarynologists, and dentists. The 4th edition, which published in 2001, has sold 2,600 copies. [books.google.de]
Eyes
- Abnormal Eye Movement
Familial agenesis of the vermis: a syndrome of episodic hyperpnea, abnormal eye movements, ataxia, and retardation. Neurology 1969; 19:813-825. 2. Boltshauser E, Isler W. [ispub.com]
Abnormal eye movements. Our patient had all the clinical symptoms with the exception of breathing abnormalities which may have been overlooked. [pediatricneurosciences.com]
In these patients, the abnormal eye movements vary and include nystagmus, strabismus, oculomotor apraxia, and vertical gaze palsy. [dovepress.com]
Other characteristic features of the condition include episodes of unusually fast (hyperpnea) or slow (apnea) breathing in infancy, and abnormal eye movements (ocular motor apraxia). [ghr.nlm.nih.gov]
Among the congenital ataxias, Joubert’s syndrome combines episodic abnormal eye movements and hyperpnea. Some have ocular motor apraxia or congenital fibrosis syndromes. [neuroophthalmology.ca]
Neurologic
- No Speech Development
[…] and/or speech development. [apraxia-kids.org]
Workup
Careful physical and genetic workups are, therefore, necessary. As the delineation of syndromes continues, the classification of this complex condition will evolve. [medlink.com]
Treatment
Treatment Treatment Options: No treatment has been reported. [disorders.eyes.arizona.edu]
Only supportive treatment is available. [emedicine.medscape.com]
The material is in no way intended to replace professional medical care by a qualified specialist and should not be used as a basis for diagnosis or treatment. [orpha.net]
Young Parents Want ‘Something More’ for Daughter with Joubert Syndrome Management of the condition and prognosis Treatment for Joubert syndrome is mainly symptomatic and supportive; thus, each treatment plan must be individualized for each child’s unique [news-medical.net]
Treatment difficulties: ◦ Varied genetic predisposition, penetrance & expressivity ◦ Recalcitrant response to therapy ◦ Associated abnormal innervation & mechanical anomalies 48. 1. [slideshare.net]
Prognosis
Prognosis Prognosis is favorable for moderate forms of the disease. Management of patients with more severe forms should be carried out at a specialized reference centre. [orpha.net]
The prognosis for infants with this syndrome depends on whether or not the cerebellar vermis is partially developed or completely absent, as well as on the severity of other organ involvement. [news-medical.net]
In addition to these, retinal and renal dysplastic changes are seen in type II, which has a worse prognosis [ 13, 14 ]. [ispub.com]
However, the prognosis is still not fully understood and its outlook is not yet documented. [jscimedcentral.com]
The syndrome is associated with progressive worsening for kidneys, the liver and the eyes and thus require regular monitoring. [4] Prognosis [ edit ] In a sample of 19 children, a 1997 study found that 3 died before the age of 3, and 2 never learned to [en.wikipedia.org]
Etiology
Etiology The syndrome is genetically heterogeneous. [orpha.net]
[…] aggressiveness self-mutilation Variants Joubert syndrome type B: association of JS with retinal dysplasia and nephronophthisis (cerebello-oculo-renal syndrome or CORS) germline mutations in RPGRIP1L JBTS3: JS with cortical polymicrogyria (AHI1 mutations) Etiology [humpath.com]
Spinocerebellar ataxia type 7 Spinocerebellar ataxia type 8 Spinocerebellar ataxia with axonal neuropathy type 1 Spinocerebellar ataxia with axonal neuropathy type 2 Spinocerebellar ataxia-dysmorphism syndrome Sporadic adult-onset ataxia of unknown etiology [se-atlas.de]
Joubert syndrome presenting with young-age onset ischemic stroke: a possible etiologic association. J Child Neurol 2011;26:381–384. 8. Kim JT, Kim SJ, Joo CU, Cho SC, Lee DY. [labmedonline.org]
Moreover, increased intracellular Ca 2+, which promotes transglutaminase activation, is of vital importance in the etiology of neurologic diseases. [emedicine.medscape.com]
Epidemiology
Nephrotoxins 1275 Urinary Tract Infections 1299 Vesicoureteral Reflux and Renal Scarring 1311 Obstructive Uropathy 1337 Bladder Dysfunction in Children 1379 Urolithiasis 1405 Pediatric Renal Tumors 1431 Epidemiology of Hypertension 1459 Pathophysiology [books.google.de]
Summary Epidemiology Prevalence is estimated at approximately 1/100,000. Clinical description In the neonatal period, the disease often manifests by an irregular breathing pattern (episodic tachypnea and/or apnea), and nystagmus. [orpha.net]
JS-R Classification (Orphanet): - Rare developmental defect during embryogenesis - Rare genetic disease - Rare neurologic disease - Rare renal disease Classification (ICD10): - Congenital malformations, deformations and chromosomal abnormalities - Epidemiological [csbg.cnb.csic.es]
Relevant External Links for TMEM67 Human Genome Epidemiology (HuGE) Navigator TMEM67 Atlas of Genetics and Cytogenetics in Oncology and Haematology: TMEM67 No data available for Genatlas for TMEM67 Gene Hypomorphic mutations in meckelin (MKS3/TMEM67) [genecards.org]
Pathophysiology
Nephrotoxins 1275 Urinary Tract Infections 1299 Vesicoureteral Reflux and Renal Scarring 1311 Obstructive Uropathy 1337 Bladder Dysfunction in Children 1379 Urolithiasis 1405 Pediatric Renal Tumors 1431 Epidemiology of Hypertension 1459 Pathophysiology [books.google.de]
Prevention
Genetic counseling is an important clinical tool for preventing new cases, especially for couples with an affected first child. The risk of having an affected child in further pregnancies is 25%. [orpha.net]
Defect Ataxia with selective vitamin E deficiency Chronic ataxia Autosomal recessive 8q13.1-q13.3 Mutated alpha-tocopherol transfer protein (ATTP) binds alpha-tocopherol, enhancing its transfer between separate membranes Vitamin E likely has a role in preventing [emedicine.medscape.com]