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Joubert syndrome

Other Names for this Disease
  • Cerebellar vermis agenesis
  • Cerebellooculorenal syndrome 1
  • Cerebelloparenchymal disorder 4
  • CORS1
  • CPD4
More Names
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Your Question

My grandson has Joubert syndrome, autism, and ADHD.  Is autism related to Joubert syndrome?

Our Answer

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What is Joubert syndrome?

Joubert syndrome is a disorder that affects many parts of the body.  The signs and symptoms vary among affected individuals, even among members of the same family.  The hallmark feature of Joubert syndrome is a brain abnormality called the molar tooth sign, which can be seen on brain imaging studies such as magnetic resonance imaging (MRI).  Most infants with Joubert syndrome have weak muscle tone (hypotonia), episodes of unusually fast or slow breathing (hyperpnoea) and abnormal eye movements.  Individuals with Joubert syndrome can have delayed development and mild to severe intellectual disabilities.   Distinctive facial features are also characteristic of Joubert syndrome.  Mutations in one of 10 known genes have been found in about half of all cases with Joubert syndrome and related disorders.  In the remaining cases, the genetic cause is unknown.  This condition typically has an autosomal recessive pattern of inheritance.  Rare cases of Joubert syndrome are inherited in an X-linked recessive pattern.[1][2]
Last updated: 8/19/2011

What are signs and symptoms of Joubert syndrome?

Most infants with Joubert syndrome have weak muscle tone (hypotonia) in infancy, which evolves into difficulty coordinating movements (ataxia) in early childhood. [1]

Other characteristic features include episodes of unusually fast or slow breathing (hyperpnea), which tends to occur shortly after birth, intensify with emotional stress and progressively improve with age, usually disappearing around the sixth month of life. [1][3]

Abnormal eye movements are also common.  Oculomotor apraxia is one of the most frequent abnormalities which causes people to have trouble moving their eyes to look side-to-side.  People with oculomotor apraxia have to turn their head to see things in their side (peripheral) vision. [3]

Developmental abilities, in particular language and motor skills, are delayed with variable degrees of severity.  Mild to severe intellectual disability is common, however some individuals may have normal intellectual abilities. [3]

Distinctive facial features are also characteristic; these include a broad forehead, arched eyebrows, droopy eyelids (ptosis), widely spaced eyes, low-set ears, and a triangle-shaped mouth.[1]

Joubert syndrome can include a broad range of additional signs and symptoms.  The condition is sometimes associated with other eye abnormalities (such as retinal dystrophy, which can cause vision loss), kidney disease, liver disease, skeletal abnormalities (such as the presence of extra fingers and toes), and hormone (endocrine) problems. When the characteristic features of Joubert syndrome occur in conbination with one or more of these additional signs, researchers refer to the conidition as "Joubert syndrome and related disorders (JSRD)" [1] or one of a subtype of Joubert syndrome.[3]
Last updated: 2/10/2011

Is there a connection between Joubert syndrome and autism?

There is a connection, but it remains somewhat unclear. Autism is a relatively common condition, occurring in 1 in 500 children, and is more likely in boys with a 4:1 male:female ratio. There are likely many different causes for this increasingly common diagnosis. Features of classical autism include poor eye contact and limited communication skills as well as repetitive or self-stimulatory behaviors. Autism has been reported in a number of children with Joubert syndrome in several publications. However, more recent surveys suggest that these behavioral disturbances do not represent classic autism, but are more likely to be related to the underlying cerebellar disorder, eye movement problems, and associated developmental disabilities. [4][5] You can read more about the question of whether there is a connection between Joubert syndrome and autism on the University of Washington School of Medicine's Joubert Research Program's Web site.  Click on the link to view their frequently asked questions.
Last updated: 2/10/2011