Presentation
Neuronal and Synaptic Dysfunction in Autism Spectrum Disorder and Intellectual Disability provides the latest information on Autism spectrum disorders (ASDs), the lifelong neurodevelopmental disorders that present in early childhood and affect how individuals [books.google.com]
Peripheral neuropathy may be present and contribute to motor disability. MRI findings are consistent with hypomyelination with minimal or extremely slow myelination. Myelin is present in the internal capsule and is usually normal in the cerebellum. [rarediseases.org]
Acknowledgments We thank the autism families presenting for genetic services and the Autism Genetic Resource Exchange. [jmg.bmj.com]
Strabismus may be present, and refractive errors, including hyperopia and astigmatism, are present in 23% to 50% of cases. Nystagmus and ptosis also are occasional ocular findings. [pediatrics.aappublications.org]
Intestinal polyps mostly present in childhood through chronic anemia, diarrhea or invagination of the small bowel. The signs and symptoms of BRRS are present from birth or become apparent in early childhood. [synapse.koreamed.org]
Entire Body System
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Recurrent Otitis Media
He had no history of seizures, hypoglycaemia, or hypotonia but did have an adenoidectomy and history of recurrent otitis media. There was a history of gestational diabetes, and a birth weight of 4.1 kg (90th centile). [jmg.bmj.com]
Chronic otitis media, seen in 60% to 80% of cases, has its onset early in life, and recurrent otitis media is present in 23% of males with fragile X syndrome. [pediatrics.aappublications.org]
Cardiovascular
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Heart Murmur
The cardiovascular and abdominal examinations were normal without heart murmur, organomegaly, or hernias. The genital examination showed freckles on the glans penis, but both testes were of normal size. [jmg.bmj.com]
Jaw & Teeth
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High Arched Palate
The craniofacial examination revealed a high arched palate. The ears were 5 cm long ( 4 SD) but normally shaped and placed. The cardiovascular and abdominal examinations were normal without heart murmur, organomegaly, or hernias. [jmg.bmj.com]
Website: www.fragilex.org.uk TABLE 1: Common physical, behavioural and developmental features of fragile-X syndrome Physical features Behavioural Features Developmental Features Broad forehead Elongated face Large, prominent ears Strabismus High arched [intellectualdisability.info]
Structural changes of the face may start to become evident in preschool years and include a long face, high forehead, high arched palate, and prominent ears. [pediatrics.aappublications.org]
Psychiatrical
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Short Attention Span
Sensory integration problems were noted as well as a short attention span. He was thought to have a pervasive developmental disorder. By exam he has one posterior hair whorl with coarse hair, joint laxity, and soft, loose skin. [jmg.bmj.com]
attention span Poor eye contact Brain tumor (astrocytoma) Benign adrenal gland tumor (adrenal adenoma) Abnormality of the brain (demyelinating brain lesions) Central nervous system infection Seizures (status epilepticus) Tall stature Increased bone age [undiagnosed.hms.harvard.edu]
attention span Impulsivity Enuresis, encopresis Autistic-like features: Gaze aversion (especially to strangers) Social anxiety & shyness Hand-flapping and hand biting Sensory defensiveness (aversion to loud noise, touch, strong smells or eye contact) [intellectualdisability.info]
The use of stimulant medication to treat hyperactivity, short attention span, and impulsivity decreases symptoms in approximately 60% to 70% of affected children but may be more effective for a child who is of school age than of preschool age. [pediatrics.aappublications.org]
Neurologic
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Progressive Macrocephaly
Because of these reports and macrocephaly seen in patients with autism, we hypothesised an association between progressive macrocephaly and autistic behaviour and PTEN gene mutations. [jmg.bmj.com]
Workup
Recently, Cooper and colleagues 82 looked at data from 15,767 patients who had undergone array CGH analysis as part of the diagnostic workup. [nejm.org]
[…] the following: Bayley Scales of Infant Development Stanford-Binet Intelligence Scale Wechsler Preschool and Primary Scale of Intelligence-Revised (WPPSI-R) Wechsler Intelligence Scale for Children–IV (WISC-IV) Vineland Adaptive Behavior Scales-II See Workup [misc.medscape.com]
Treatment
The treatment of emotional and behavioral problems. In: FXS: Diagnosis, treatment, and research, 3rd ed, Hagerman, RJ, Hagerman, PJ (Eds), Johns Hopkins University Press, Baltimore 2002. p.339-362 22. Lachiewicz AM, Dawson DV. [intellectualdisability.info]
While most of these treatments have not been rigorously tested for safety and efficacy, there is growing interest in these treatments, with more studies looking into the possible benefits of CAM treatments. [medicalhomeportal.org]
Treatment is usually long term. It often involves medication. There are some behaviour treatments that work. [raisingchildren.net.au]
Identifying genetic causes is critical to tailoring treatments to the child. [spectrumnews.org]
Researchers hope to identify cognitive, neural systems, and molecular biomarkers specific to PTEN ASD that may serve as treatment targets. [childrenshospital.org]
Prognosis
There aren't biochemical markers for the disease. [10] Treatment [ edit ] Treatment is symptomatic. [10] There is no standard course of treatment for Sotos syndrome. [ citation needed ] Prognosis [ edit ] Sotos syndrome is not a life-threatening disorder [en.wikipedia.org]
Review the clinical manifestations, the variability seen in fragile X syndrome, and the long-term prognosis. Review currently available treatments and interventions. [pediatrics.aappublications.org]
Early brain imaging results have the potential to provide a more accurate prognosis as well as lead to a better understanding of neurological symptoms and responses to therapies. [childrenshospital.org]
Genetic counselling aims to educate families about the syndrome, its implications and prognosis, supporting them in making informed decisions about the future and in dealing with the emotional impact of the diagnosis. [intellectualdisability.info]
Prognosis Prognosis depends on many factors and is difficult to predict, particularly in the young child. [medicalhomeportal.org]
Etiology
While it is clear that genetics can play a role in the development of certain patients, approximately 90% of patients with ASD do not have a genetic etiology identified. [cincinnatichildrens.org]
Array comparative genomic hybridization (aCGH) and exome sequencing, together with systems genetics and network analyses, are being used as tools for the study of complex disorders of unknown etiology, especially those characterized by significant genetic [mdanderson.influuent.utsystem.edu]
[…] retardation, language delay, extreme macrocephaly ( 4.7SD) with a prominent forehead, and digital minor anomalies.ConclusionChildren with macrocephaly, particularly males, are at a higher risk of neurodevelopmental disorders, rather than progressive etiologies [medicinebyalexandrosgsfakianakisblog.wordpress.com]
Abnormalities of dentition or the palate may suggest a genetic etiology. Heart Cardiac murmurs or defects may suggest a genetic syndrome. [medicalhomeportal.org]
Developmental delays vary depending on the level of MR/ID and the etiology. [misc.medscape.com]
Epidemiology
Paediatric and Perinatal Epidemiology, 22 (2), 180–187. doi: 10.1111/j.1365-3016.2007.00897.x. CrossRef PubMed Leyfer, O. T., Folstein, S. E., Bacalman, S., Davis, N. O., Dinh, E., Morgan, J., et al. (2006). [mijn.bsl.nl]
Epidemiology [ edit ] Incidence is approximately 1 in 14,000 births. [11] See also [ edit ] Perlman syndrome Beckwith-Wiedemann syndrome References [ edit ] "7-foot-tall Broc Brown: Facts". Morning News USA. Retrieved 8 March 2017. [en.wikipedia.org]
Epidemiology of Autism Spectrum Disorders. The Pediatric Clinics of North America. 2012;59(1):27-43. [medicalhomeportal.org]
Mental Subnormality in the Community: A Clinical and Epidemiologic Study. Baltimore: Williams & Wilkins; 1970. Strauss D, Eyman RK. Mortality of people with mental retardation in California with and without Down syndrome, 1986-1991. [misc.medscape.com]
Epidemiology There are about 100–200 affected births in the UK each year. The population prevalence is estimated at 1 in 4000 males and 1 in 8000 females (Hagerman and Hagerman, 2002). It occurs in all races and ethnic groups. [intellectualdisability.info]
Pathophysiology
X syndrome, and other autism spectrum disorders, as well as their classification as synaptopathies Presents a thorough discussion of the clinical aspects of multiple neurodevelopmental disorders and the experimental models that exist to study their pathophysiology [books.google.com]
This observation also suggests that generalized overgrowth might represent a “biomarker” associated with one or more homogeneous clinical and pathophysiological subtypes of ASD [33]. [journals.plos.org]
Decreased expression of axon-guidance proteins, as PLXNA4, was found in the brains of people with ASD, suggesting that dysfunctional axon-guidance protein expression may play an important role in the pathophysiology of autism [ 9 ]. [omicsonline.org]
References Pathophysiology MR/ID is the end result of many disorders of CNS function. Most individuals with significant intellectual impairment have no discernible structural abnormalities of the brain. [misc.medscape.com]
Prevention
CrossRef PubMed Developmental Disabilities Monitoring Network Surveillance Year 2010 Principal Investigators, Centers for Disease Control and Prevention (CDC). (2014). [mijn.bsl.nl]
The lack of this enzyme prevents cholesterol from being converted into a bile acid called chenodexoycholic acid. [rarediseases.org]
Genetic changes involving the NSD1 gene prevent one copy of the gene from producing any functional protein. [en.wikipedia.org]
Recommendations for preventive pediatric health care. Pediatrics. 2007 ; 120 ( 6 ): 1376 34. 35. Copyright 2011 by the American Academy of Pediatrics View Abstract [pediatrics.aappublications.org]
Because we cannot predict which cancers may develop, additional medical management strategies focused on cancer prevention and early detection may benefit most patients who are found to have a pathogenic variant. [invitae.com]