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NEUROLOGY
Diagnosed at 2,
Rett
Syndrome
Lauren was a beautiful, healthy 2
year-old, sitting up and beginning to talk, when her mother, Sheri,
started to notice something wasn’t quite right. It was nothing
dramatic, but she noticed her daughter wasn’t crawling or saying
certain words like the books said she should.
Sheri began to take Lauren to one
doctor after another, but all told her everything was O.K. Finally
one mentioned a possibility Sheri had never even heard of – Rett
Syndrome (RS), a neurological disorder that affects one in 20,000
children, almost always girls. Months later, the diagnosis was
official, and today, at 5 years old, Lauren does not speak and can
walk only with assistance.
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Groundbreaking discovery
brings hope one step closer
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With the discovery of the
gene that causes Rett Syndrome, a research team at Texas Children’s
and Baylor College of Medicine has brought a cure for the enigmatic
disorder one step closer.
Led by Dr. Huda Zoghbi,
Texas Children’s neurology service and professor of pediatrics,
Baylor College of Medicine, the team traced the problem to a
defective gene on the X chromosome called MECP2. It plays a
significant role in “silencing” or turning off other genes. Rett
syndrome is the first human disease found that is caused by
mutations in this type of gene.
Zoghbi is hopeful that
knowing the genetic cause of Rett syndrome will make it possible to
treat or prevent the disorder.
“Now that we know the
problem gene, we can explore the possibility of developing
treatments that could be given in early infancy before symptoms
appear,” she said.
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Although Lauren’s story may sound
unusual, Dr. Daniel Glaze,
director of the
Blue Bird
Circle Rett Center at Texas Children’s Hospital, one of the
world’s foremost centers for treatment and study of RS, has heard it
hundreds of times.
“Sometimes there are subtle signs
something is wrong, but usually these girls develop normally the
first year or so,” says Glaze. “However, at 1-1/2 to 2 years old
there is a dramatic change, and it is clear that everything is not
all right.”
In short order, the girls lose spoken
language skills and purposeful use of their hands. They develop
repetitive hand movements and gait disturbances, and they may begin
to have epileptic seizures and abnormal breathing patterns,
including holding their breath while awake. Head and body growth
slows, and three to six years after onset of RS the girls show
little or poor growth. Some who previously walked stop, and many
develop scoliosis, spasticity and features of Parkinson’s disease.
Glaze and project coordinator Judy
Barrish, RN, say the girls they see have definite personalities,
preferences and possibilities.
“They are capable of doing much more
than we can imagine,” Glaze says. “We are constantly amazed and
impressed at what they can do. They like being around others and
communicate their preferences nonverbally. They show pain and
happiness.”
Although there is no cure for RS,
therapy can often help. To their patients, who come from all over
the world, the Rett Center offers a multidisciplinary approach
including therapy – physical, occupational, water, music and
communication – as well as an intensive nutritional program. Many
enjoy hippotherapy, or horseback riding, and it helps with balance.
Research, including genetic
breakthroughs, holds promise for the future of both treatment and
prevention. Since the discovery of the gene that causes RS (see
inset), physicians are able to diagnose it earlier and determine if
mothers may pass the gene to other daughters. The Rett Center is
involved in several research projects focused on seizures, nutrition
and therapy. Many girls with RS have osteoporosis, and one important
study is researching causes and treatment of this problem.
Lauren, now 5, attends a mainstream
school, where the children are kind and protective of her. Sheri
gets a lot of support from parents of other Rett children, and she
reads everything she can about RS. She finds hope in each new
advance and joy in Lauren’s small triumphs.
Kids Courageous home |
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