Rett
Syndrome
Presenter,
Jeevan kishore
Group : 16
oNeurodevelopment disorder
oappearing in girls during infancy and early
childhood
omutations in the methyl-CpG-binding protein 2
(MECP2) gene
olose skills such as the ability to crawl, walk,
communicate or use their hands
Genetic Basis
oIt is an x-linked dominant genetic disorder
oIt is largely sporadic
oMore than 95% of females meeting RS consensus criteria will
have mutations
oIn MECP2. MECP2, located at xq28
oThe mutation appears to result in problems with the protein
production critical for brain development.
Symptoms
oMicrocephaly
oLoss of normal movement
and coordination
oLoss of communication
abilities
oAbnormal hand
movements
oUnusual eye movements
oBreathing problems
oCognitive disabilities
oSeizures
oAbnormal curvature of the
spine
oIrregular heartbeat
oPain
Stage 1: early
onset.
Stage 2: rapid
destruction
Stage 3: plateau
Stage 4: late motor
deterioration
Stages of Rett
syndrome
Stage 1o early onset.
o starts between 6 and 18 months of age
o can last for a few months or a year.
o Babies show less eye contact and start to lose
interest in toys.
o They may also have delays in sitting or
crawling.
Stage 2o rapid destruction
oStarting between 1 and 4 years of age, children lose
the ability to perform skills they had earlier.
oSymptoms occur, such as slowed head growth,
abnormal hand movements, hyperventilating,
screaming or crying, problems with movement and
coordination, and a loss of social interaction and
communication.
o Between the ages of 2 and 10 years and can last for
many years.
o Problems with movement continue, behavior may
have limited improvement, with less crying and
irritability, and some improvement in hand use and
communication.
o Seizures may begin
Stage 3
Stage 4
obegins after the age of 10 and can last for years or
decades.
oIt's marked by reduced mobility, muscle weakness,
joint contractures and scoliosis.
oUnderstanding, communication and hand skills
generally remain stable or improve slightly, and
seizures may occur less often.
Diagnosis
o Physical exam and detailed information about the
child’s development and medical history.
o Genetic DNA blood test to support the diagnosis
o CT scan, MRI scan
o Electroencephalograms
Criteria for diagnosis
The guidelines for diagnosing Rett syndrome are divided
into three types:
Essential
Exclusion
Supportive
Essential criteria
o A period of normal development until between 6
to 18 months followed by a loss of skills, then
recovery or stabilization of skills
o Partial or complete loss of purposeful hand skills
o Partial or complete loss of spoken language
o Dyspraxic gait
o Repetitive hand
Supportive criteria
obreathing irregularities while awake, such as apnea,
hyperventilation and air swallowing
oteeth-grinding
oabnormal sleep patterns
oabnormal muscle tone (hypotonia, rigidity or
spasticity)
oscoliosis or kyphosis (curvature of the spine)
odelayed growth
osmall hands and feet
oinappropriate laughing or screaming spells
oreduced response to pain
ointense eye communication or “eye pointing”
opoor circulation in the hands and feet, with cold and
bluish to red hands and feet
Exclusion criteria
o a neurometabolic disease or other inherited
degenerative disorder
o a neurological disorder resulting from severe infection
or head trauma
o evidence of brain damage acquired after birth
o grossly abnormal development in the first six months
of life
Treatment
There is no currently targeted treatment or gene therapy
oPhysical therapy
oOccupational therapy
oSpeech-language therapy
oNutritional support
oBehavioral intervention
oSupport services
Supportive
care
Rett syndrome

Rett syndrome

  • 1.
  • 2.
    oNeurodevelopment disorder oappearing ingirls during infancy and early childhood omutations in the methyl-CpG-binding protein 2 (MECP2) gene olose skills such as the ability to crawl, walk, communicate or use their hands
  • 3.
    Genetic Basis oIt isan x-linked dominant genetic disorder oIt is largely sporadic oMore than 95% of females meeting RS consensus criteria will have mutations oIn MECP2. MECP2, located at xq28 oThe mutation appears to result in problems with the protein production critical for brain development.
  • 4.
    Symptoms oMicrocephaly oLoss of normalmovement and coordination oLoss of communication abilities oAbnormal hand movements oUnusual eye movements oBreathing problems oCognitive disabilities oSeizures oAbnormal curvature of the spine oIrregular heartbeat oPain
  • 5.
    Stage 1: early onset. Stage2: rapid destruction Stage 3: plateau Stage 4: late motor deterioration Stages of Rett syndrome
  • 6.
    Stage 1o earlyonset. o starts between 6 and 18 months of age o can last for a few months or a year. o Babies show less eye contact and start to lose interest in toys. o They may also have delays in sitting or crawling.
  • 7.
    Stage 2o rapiddestruction oStarting between 1 and 4 years of age, children lose the ability to perform skills they had earlier. oSymptoms occur, such as slowed head growth, abnormal hand movements, hyperventilating, screaming or crying, problems with movement and coordination, and a loss of social interaction and communication.
  • 8.
    o Between theages of 2 and 10 years and can last for many years. o Problems with movement continue, behavior may have limited improvement, with less crying and irritability, and some improvement in hand use and communication. o Seizures may begin Stage 3
  • 9.
    Stage 4 obegins afterthe age of 10 and can last for years or decades. oIt's marked by reduced mobility, muscle weakness, joint contractures and scoliosis. oUnderstanding, communication and hand skills generally remain stable or improve slightly, and seizures may occur less often.
  • 10.
    Diagnosis o Physical examand detailed information about the child’s development and medical history. o Genetic DNA blood test to support the diagnosis o CT scan, MRI scan o Electroencephalograms
  • 11.
    Criteria for diagnosis Theguidelines for diagnosing Rett syndrome are divided into three types: Essential Exclusion Supportive
  • 12.
    Essential criteria o Aperiod of normal development until between 6 to 18 months followed by a loss of skills, then recovery or stabilization of skills o Partial or complete loss of purposeful hand skills o Partial or complete loss of spoken language o Dyspraxic gait o Repetitive hand
  • 13.
    Supportive criteria obreathing irregularitieswhile awake, such as apnea, hyperventilation and air swallowing oteeth-grinding oabnormal sleep patterns oabnormal muscle tone (hypotonia, rigidity or spasticity)
  • 14.
    oscoliosis or kyphosis(curvature of the spine) odelayed growth osmall hands and feet oinappropriate laughing or screaming spells oreduced response to pain ointense eye communication or “eye pointing” opoor circulation in the hands and feet, with cold and bluish to red hands and feet
  • 15.
    Exclusion criteria o aneurometabolic disease or other inherited degenerative disorder o a neurological disorder resulting from severe infection or head trauma o evidence of brain damage acquired after birth o grossly abnormal development in the first six months of life
  • 16.
    Treatment There is nocurrently targeted treatment or gene therapy oPhysical therapy oOccupational therapy oSpeech-language therapy oNutritional support oBehavioral intervention oSupport services Supportive care