Spastic Paraplegia, Intellectual Disability, Nystagmus, and Obesity

Background and History: 

This rare inherited syndrome has been reported in 3 unrelated patients.

Clinical Correlations: 

Newborns have deep-set eyes and a prominent forehead with chubby cheeks.  They grow rapidly in infancy and approach the 90th percentile in weight and height in the first year of life. Obesity may be an issue.  They often have some floppiness in their trunk (central body) but the limbs can be stiff with increased reflexes.  They are intellectually delayed and may not be able to speak or walk until mid-childhood.

Brain imaging (MRI) shows delayed maturation of various structures.

The eyes may not be properly aligned (strabismus) and often have a constant to-and-fro motion (nystagmus).  Vision is generally poor.

Genetics: 

This is an autosomal dominant disorder caused by a change (mutation) in a specific gene.  Three unrelated children have been reported must likely due to a new mutation since affected individuals are too severely delayed to reproduce and the gene change cannot be transmitted.

Diagnosis and Prognosis: 

The diagnosis can be suspected at birth based on the facial morphology although the signs are not specific.  It is likely that pediatricians and neurologists would collaborate on the diagnostic evaluation and supportive care required.  The eye signs should be evaluated by a medical eye doctor (ophthalmologist).

No treatment has been reported.  Strabismus can be surgically corrected although the potential benefits should be discussed on an individual basis with the family.  Obesity treatment is not useful generally.

Nothing is known regarding longevity.

Additional Information
Inheritance/Pedigree: 
Autosomal dominant