Treatable Intellectual Disability

Menkes Disease Occipital Horn Syndrome

DIAGNOSIS

Gene
ATP7A (AR)

Diagnostic Test
Serum Copper & Ceruloplasmin; Urine Deoxypyridonoline

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SIGNS & SYMPTOMS

Neurological
Epilepsy

Non-Neurological
Dysmorphisms, feeding problems and diarrhea, demineralization, exostoses, skin laxicity, pilli torti

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THERAPY

Treatment
Copper Histidine

Level of Evidence
4

Clinical Practice
Individual Basis

Treatment Effect
Stabilizes clinical deterioration



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Menkes Disease Occipital Horn Syndrome

Occipital horn syndrome (OHS) is a mild form of Menkes disease, a syndrome characterized by progressive neurodegeneration and connective tissue disorders due to a copper transport defect. There is a continuum of severity from Menkes disease to OHS spanning from severe developmental delay, muscular hypotonia, epilepsy, to loose skin (predominantly at the back of the neck), bladder diverticula and vascular tortuosity. Pili torti are characteristic hair abnormalities. Connective tissue abnormalities with various degrees of neurodevelopmental delay represents the mild end of the spectrum. Bone disease with demineralisation, exostosis particularly at the occipital insertion of the paraspinal muscles (hence the name) are characteristic.

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