Rett syndrome

Rett syndrome
Synonyms	Cerebroatrophic hyperammonemia
Pronounce	N/A
Field	Psychiatry, pediatrics
Symptoms	Problems with language, coordination, and repetitive movements, slower growth, smaller head
Complications	Seizures, scoliosis, sleeping problems
Onset	After 6 to 18 months of age
Duration	Lifelong
Types
Causes	Mutation of the MECP2 gene
Risks
Diagnosis	Based on symptoms, genetic testing
Differential diagnosis	Angelman syndrome, autism, cerebral palsy, various neurodegenerative disorders
Prevention
Treatment	Special education, physiotherapy, braces
Medication	Anticonvulsants
Prognosis	Life expectancy for many is middle age
Frequency	1 in 8,500 females
Deaths

Rett syndrome

Rett syndrome

File:Rett Girl Mouthing.jpg

Rett syndrome

File:Rett girl with stereotyped hands movements.jpg

Rett syndrome

Rett Syndrome (RTT) is a genetic neurological disorder primarily affecting females, characterized by a progression of multiple impairments affecting language, motor skills, and growth. It typically manifests between 6 to 18 months of age. While symptoms and their severity can vary, common issues include language and coordination difficulties, repetitive movements, growth retardation, problems with walking, and a reduced head size. Seizures, scoliosis, and sleep disturbances are notable complications. Despite these challenges, individuals with Rett Syndrome can often live into middle age.

Etiology

Rett Syndrome is caused by a genetic mutation, specifically in the MECP2 gene on the X chromosome. The mutation is typically de novo, arising spontaneously rather than being inherited from parents, accounting for less than one percent of cases. As the mutation occurs on the X chromosome, the condition almost exclusively affects girls; boys with a similar mutation generally do not survive beyond infancy.<ref>,

 Rett Syndrome: A Genetic Update and Clinical Review Focusing on Comorbidities, 
 ACS Chemical Neuroscience, 
 
 
 
 DOI: 10.1021/acschemneuro.7b00346,
 
 
 
 
 Accessed on: 2023-05-18.</ref>

Diagnosis

Diagnosis of Rett Syndrome is symptom-based and can be confirmed with genetic testing to detect the MECP2 mutation. The diagnostic criteria encompass postnatal deceleration of head growth, loss of acquired purposeful hand skills followed by repetitive movements, social engagement impairments, poorly coordinated gait, and severe language development deficits.<ref>,

 Rett Syndrome: Revised Diagnostic Criteria and Nomenclature, 
 Annals of Neurology, 
 
 
 
 DOI: 10.1002/ana.22124,
 
 
 
 
 Accessed on: 2023-05-18.</ref>

Treatment and Management

While there is currently no cure for Rett Syndrome, symptom management is crucial to enhance the quality of life. Therapies include special education programs, physiotherapy, occupational therapy, speech therapy, and use of orthotic devices. Anticonvulsant medications can help manage seizures. Nutritional support is often necessary due to chewing and swallowing difficulties.<ref>,

 Rett Syndrome: Therapeutic Strategies and Future Perspectives, 
 The Journal of Neuroscience Research, 
 
 
 
 DOI: 10.1002/jnr.24446,
 
 
 
 
 Accessed on: 2023-05-18.</ref>

Epidemiology

Rett Syndrome is a rare disorder, affecting approximately 1 in 8,500 females.<ref>,

 Rett Syndrome: A Pervasive Neurodevelopmental Disorder with Socioeconomic Impact, 
 Public Health Genomics, 
 
 
 
 DOI: 10.1159/000329420,
 
 
 
 
 Accessed on: 2023-05-18.</ref>

History

Rett Syndrome was first described in 1966 by Andreas Rett, a Viennese pediatrician. His findings, initially published in German, did not receive global attention until 1983, when Swedish pediatrician Bengt Hagberg published an article in English and named the syndrome after Rett. The causative mutation in the MECP2 gene was discovered in 1999 by Lebanese-American physician Huda Zoghbi.<ref>,

 The Story of Rett Syndrome: From Clinic to Neurobiology, 
 Neuron, 
 
 
 
 DOI: 10.1016/j.neuron.2008.10.015,
 
 
 
 
 Accessed on: 2023-05-18.</ref>

Research Directions

While the current management of Rett Syndrome focuses on symptomatic treatment, recent advances in understanding the molecular pathogenesis have opened up possibilities for targeted therapeutics. Preclinical studies have indicated that the neurological dysfunction in Rett Syndrome might be reversible, paving the way for new strategies that could restore normal neuronal function.<ref>,

 Rett Syndrome and the Ongoing Therapeutic Renaissance, 
 Current Opinion in Psychiatry, 
 
 
 
 DOI: 10.1097/YCO.0000000000000561,
 
 
 
 
 Accessed on: 2023-05-18.</ref>

See Also

• Genetic disorder
• MECP2
• X chromosome
• Neurological disorders
• Seizures
• Scoliosis
• Sleep disorders
• Special education
• Physiotherapy

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