eMedicine Specialties > Neurology > Pediatric Neurology

Lesch-Nyhan Syndrome: Follow-up

Author: H A Jinnah, MD, PhD, Professor, Departments of Neurology and Human Genetics, Emory University
Contributor Information and Disclosures

Updated: Dec 15, 2008

Follow-up

Further Inpatient Care

  • Inpatient admissions should be limited to those absolutely necessary for medical interventions, since moving these patients into an unfamiliar environment will exacerbate behavioral problems such as self-injury.
  • Restraints should be applied at all times to prevent self-injury; this includes nighttime sleeping periods and also during transfer for any tests. This disease is one of a few rare conditions that are exempted from the usual regulations of the Joint Commission on Accreditation of Healthcare Organizations (JCAHO) against continuous and long-term patient restraints.

Deterrence/Prevention

  • Since few reliable treatments are available for the condition, genetic counseling is critical for prevention. Mothers and sisters of patients should be tested to determine if they are carriers.
  • Prenatal testing should be offered to all pregnant women known to be carriers. Because of the rare potential for gonadal mosaicism, prenatal testing should also be offered to mothers who have previously given birth to an affected individual, even if she does not appear to be a carrier.

Prognosis

  • With optimal medical care, affected individuals typically live into their third or even fourth decade of life.
  • Many die from aspiration pneumonia or complications from chronic nephrolithiasis and renal failure; however, a significant proportion of patients die suddenly and unexpectedly from unknown causes.
 


More on Lesch-Nyhan Syndrome

Overview: Lesch-Nyhan Syndrome
Differential Diagnoses & Workup: Lesch-Nyhan Syndrome
Treatment & Medication: Lesch-Nyhan Syndrome
Follow-up: Lesch-Nyhan Syndrome
Multimedia: Lesch-Nyhan Syndrome
References

References

  1. Alford RL, Redman JB, O'Brien WE, et al. Lesch-Nyhan syndrome: carrier and prenatal diagnosis. Prenat Diagn. Apr 1995;15(4):329-38. [Medline].

  2. Jinnah HA, Friedmann T. Lesch-Nyhan disease and its variants. In: Scriver CR, Sly WS, Childs B, Beaudet AL, et al, eds. The Molecular and Metabolic Bases of Inherited Disease. 6th ed. New York, NY: McGraw-Hill; 2000:Chapter 107.

  3. Jinnah HA, De Gregorio L, Harris JC, et al. The spectrum of inherited mutations causing HPRT deficiency: 75 new cases and a review of 196 previously reported cases. Mutat Res. Oct 2000;463(3):309-26. [Medline].

  4. Jinnah HA, Visser JE, Harris JC, et al. Delineation of the motor disorder of Lesch-Nyhan disease. Brain. May 2006;129(Pt 5):1201-17. [Medline].

  5. Lesch M, Nyhan WL. A familial disorder of uric acid metabolism and central nervous system function. Am J Med. Apr 1964;36:561-70. [Medline].

  6. Nyhan WL, Vuong LU, Broock R. Prenatal diagnosis of Lesch-Nyhan disease. Prenat Diagn. Oct 2003;23(10):807-9. [Medline].

  7. Visser JE, Bar PR, Jinnah HA. Lesch-Nyhan disease and the basal ganglia. Brain Res Brain Res Rev. Apr 2000;32(2-3):449-75. [Medline].

Further Reading

Keywords

HPRT deficiency, hypoxanthine-guanine phosphoribosyl transferase, Kelley-Seegmiller syndrome, Lesch-Nyhan disease, overproduction of uric acid, neurologic disability, behavioral problems, hyperuricemia, nephrolithiasis with renal failure, gouty arthritis, tophi, dystonia, choreoathetosis, ballismus, spasticity, hyperreflexia, cognitive dysfunction, aggressive behaviors, impulsive behaviors, self-injurious behavior

Contributor Information and Disclosures

Author

H A Jinnah, MD, PhD, Professor, Departments of Neurology and Human Genetics, Emory University
H A Jinnah, MD, PhD is a member of the following medical societies: American Academy of Neurology, American Neurological Association, Movement Disorders Society, and Society for Neuroscience
Disclosure: Nothing to disclose.

Medical Editor

Robert Baumann, MD, Program Director, Professor, Departments of Neurology and Pediatrics, University of Kentucky
Robert Baumann, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Pediatrics, American College of Epidemiology, American Epilepsy Society, and Child Neurology Society
Disclosure: Nothing to disclose.

Pharmacy Editor

Francisco Talavera, PharmD, PhD, Senior Pharmacy Editor, eMedicine
Disclosure: Nothing to disclose.

Managing Editor

Kenneth J Mack, MD, PhD, Senior Associate Consultant, Department of Child and Adolescent Neurology, Mayo Clinic
Kenneth J Mack, MD, PhD is a member of the following medical societies: American Academy of Neurology, Child Neurology Society, Phi Beta Kappa, and Society for Neuroscience
Disclosure: Nothing to disclose.

CME Editor

Selim R Benbadis, MD, Professor, Director of Comprehensive Epilepsy Program, Departments of Neurology and Neurosurgery, University of South Florida School of Medicine, Tampa General Hospital
Selim R Benbadis, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Sleep Medicine, American Clinical Neurophysiology Society, American Epilepsy Society, and American Medical Association
Disclosure: Nothing to disclose.

Chief Editor

Amy Kao, MD, Assistant Professor, Department of Neurology, Division of Pediatrics, Department of Pediatrics, Oregon Health and Science University; Consulting Staff, Shriners Hospital for Children
Amy Kao, MD is a member of the following medical societies: American Academy of Neurology, American Academy of Pediatrics, American Epilepsy Society, and Child Neurology Society
Disclosure: Nothing to disclose.

 
 
HONcode

We subscribe to the
HONcode principles of the
Health On the Net Foundation

All material on this website is protected by copyright, Copyright© 1994- by Medscape.
This website also contains material copyrighted by 3rd parties.

DISCLAIMER: The content of this Website is not influenced by sponsors. The site is designed primarily for use by qualified physicians and other medical professionals. The information contained herein should NOT be used as a substitute for the advice of an appropriately qualified and licensed physician or other health care provider. The information provided here is for educational and informational purposes only. In no way should it be considered as offering medical advice. Please check with a physician if you suspect you are ill.