• Definition: X-linked disorder with progressive loss of intelligence and cognitive abilities such as language, locomotion, and fine motor skills

A kind of regression, like the one in Ego defenses

Rett for Regress

  • Etiology: X-linked dominant gene mutation in methyl-CpG binding protein 2 gene (MECP2 gene)
    • Neuropathology is consistent with arrested brain development (eg, impaired dendritic maturation, reduced neuromelanin in substantia nigra) rather than death of neurons (ie, neurodegeneration).
    • Usually not an inherited gene defect, but rather a sporadic mutation
    • Mutation usually occurs in the paternal allele; thus, females are almost exclusively affected
    • If affected, male fetuses die in utero or shortly after birth.
  • Clinical features
    • Normal development until the first symptoms appear, which typically happens at 6–18 months of age
    • Symptoms of neurodevelopmental regression, including:
      • Loss of motor skills, especially targeted hand movements (affected children show characteristic hand wringing)Pasted image 20240505102026.png
      • Truncal ataxia, apraxia, choreatic movements
      • Intellectual and verbal disability
      • Seizures
      • Growth failure
      • Scoliosis