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Hyperekplexia

MedGen UID:
488800
Concept ID:
C0234166
Sign or Symptom
Synonym: Hyperekplexias
SNOMED CT: Hyperekplexia (19557000); Startle syndrome (19557000); Hyperexplexia (19557000)
 
Related genes: ATAD1, ARHGEF9, GPHN, SLC6A5, GLRB, GLRA1
 
Monarch Initiative: MONDO:0017658
Orphanet: ORPHA306773

Definition

Hereditary hyperekplexia is a condition in which affected infants have increased muscle tone (hypertonia) and an exaggerated startle reaction to unexpected stimuli, especially loud noises. Following the startle reaction, infants experience a brief period in which they are very rigid and unable to move. During these rigid periods, some infants stop breathing, which, if prolonged, can be fatal. Infants with hereditary hyperekplexia have hypertonia at all times, except when they are sleeping.

The signs and symptoms of hereditary hyperekplexia typically fade by age 1. However, older individuals with hereditary hyperekplexia may still startle easily and have periods of rigidity, which can cause them to fall down. They may also continue to have hypnagogic myoclonus or movements during sleep. As they get older, individuals with this condition may have a low tolerance for crowded places and loud noises. People with hereditary hyperekplexia who have epilepsy have the seizure disorder throughout their lives.

Other signs and symptoms of hereditary hyperekplexia can include muscle twitches when falling asleep (hypnagogic myoclonus) and movements of the arms or legs while asleep. Some infants, when tapped on the nose, extend their head forward and have spasms of the limb and neck muscles. Rarely, infants with hereditary hyperekplexia experience recurrent seizures (epilepsy).

Hereditary hyperekplexia may explain some cases of sudden infant death syndrome (SIDS), which is a major cause of unexplained death in babies younger than 1 year. [from MedlinePlus Genetics]

Professional guidelines

PubMed

Masri A, Chung SK, Rees MI
Brain Dev 2017 Apr;39(4):306-311. Epub 2016 Nov 11 doi: 10.1016/j.braindev.2016.10.010. PMID: 27843043
Cross JH
Semin Fetal Neonatal Med 2013 Aug;18(4):192-5. Epub 2013 Apr 30 doi: 10.1016/j.siny.2013.04.003. PMID: 23642846
Dreissen YE, Tijssen MA
Epilepsia 2012 Dec;53 Suppl 7:3-11. doi: 10.1111/j.1528-1167.2012.03709.x. PMID: 23153204

Recent clinical studies

Etiology

Zhan FX, Wang SG, Cao L
Neurol Sci 2021 Oct;42(10):4095-4107. Epub 2021 Aug 11 doi: 10.1007/s10072-021-05493-8. PMID: 34379238
Balint B, Vincent A, Meinck HM, Irani SR, Bhatia KP
Brain 2018 Jan 1;141(1):13-36. doi: 10.1093/brain/awx189. PMID: 29053777Free PMC Article
Dreissen YE, Bakker MJ, Koelman JH, Tijssen MA
Clin Neurophysiol 2012 Jan;123(1):34-44. Epub 2011 Oct 26 doi: 10.1016/j.clinph.2011.09.022. PMID: 22033030
Bakker MJ, van Dijk JG, van den Maagdenberg AM, Tijssen MA
Lancet Neurol 2006 Jun;5(6):513-24. doi: 10.1016/S1474-4422(06)70470-7. PMID: 16713923
Fejerman N
Indian J Pediatr 1997 Sep-Oct;64(5):583-602. doi: 10.1007/BF02726110. PMID: 10771893

Diagnosis

Carapancea E, Cornet MC, Milh M, De Cosmo L, Huang EJ, Granata T, Striano P, Ceulemans B, Stein A, Morris-Rosendahl D, Conti G, Mitra N, Raymond FL, Rowitch DH, Solazzi R, Vercellino F, De Liso P, D'Onofrio G, Boniver C, Danhaive O, Carkeek K, Salpietro V, Weckhuysen S, Fedrigo M, Angelini A, Castellotti B, Lederer D, Benoit V, Raviglione F, Guerrini R, Dilena R, Cilio MR
Neurology 2023 Mar 21;100(12):e1234-e1247. Epub 2023 Jan 4 doi: 10.1212/WNL.0000000000206755. PMID: 36599696Free PMC Article
Saini AG, Pandey S
J Neurol Sci 2020 Sep 15;416:117051. Epub 2020 Jul 20 doi: 10.1016/j.jns.2020.117051. PMID: 32721683
Espay AJ, Chen R
Continuum (Minneap Minn) 2013 Oct;19(5 Movement Disorders):1264-86. doi: 10.1212/01.CON.0000436156.54532.1a. PMID: 24092290
Bakker MJ, van Dijk JG, van den Maagdenberg AM, Tijssen MA
Lancet Neurol 2006 Jun;5(6):513-24. doi: 10.1016/S1474-4422(06)70470-7. PMID: 16713923
Brown P
Curr Opin Neurol 1996 Aug;9(4):314-6. doi: 10.1097/00019052-199608000-00013. PMID: 8858191

Therapy

Vuilleumier PH, Fritsche R, Schliessbach J, Schmitt B, Arendt-Nielsen L, Zeilhofer HU, Curatolo M
Brain 2018 Jan 1;141(1):63-71. doi: 10.1093/brain/awx289. PMID: 29149236
Freissmuth M, Stockner T, Sucic S
Handb Exp Pharmacol 2018;245:249-270. doi: 10.1007/164_2017_71. PMID: 29086036
Espay AJ, Chen R
Continuum (Minneap Minn) 2013 Oct;19(5 Movement Disorders):1264-86. doi: 10.1212/01.CON.0000436156.54532.1a. PMID: 24092290
Shahar E, Raviv R
Pediatr Neurol 2004 Jul;31(1):30-4. doi: 10.1016/j.pediatrneurol.2003.12.007. PMID: 15246489
Zhou L, Chillag KL, Nigro MA
Brain Dev 2002 Oct;24(7):669-74. doi: 10.1016/s0387-7604(02)00095-5. PMID: 12427512

Prognosis

Ferraroli E, Perulli M, Veredice C, Contaldo I, Quintiliani M, Ricci M, Venezia I, Citrigno L, Qualtieri A, Spadafora P, Cavalcanti F, Battaglia DI
Pediatr Neurol 2022 Jul;132:45-49. Epub 2022 May 17 doi: 10.1016/j.pediatrneurol.2022.05.002. PMID: 35636282
Gupta J, Badal S, Anand V, Jauhari P, Chakrabarty B, Gulati S
Neurol India 2022 Jan-Feb;70(1):312-314. doi: 10.4103/0028-3886.338670. PMID: 35263902
Cross JH
Semin Fetal Neonatal Med 2013 Aug;18(4):192-5. Epub 2013 Apr 30 doi: 10.1016/j.siny.2013.04.003. PMID: 23642846
Shahar E, Raviv R
Pediatr Neurol 2004 Jul;31(1):30-4. doi: 10.1016/j.pediatrneurol.2003.12.007. PMID: 15246489
Fejerman N
Indian J Pediatr 1997 Sep-Oct;64(5):583-602. doi: 10.1007/BF02726110. PMID: 10771893

Clinical prediction guides

Carapancea E, Cornet MC, Milh M, De Cosmo L, Huang EJ, Granata T, Striano P, Ceulemans B, Stein A, Morris-Rosendahl D, Conti G, Mitra N, Raymond FL, Rowitch DH, Solazzi R, Vercellino F, De Liso P, D'Onofrio G, Boniver C, Danhaive O, Carkeek K, Salpietro V, Weckhuysen S, Fedrigo M, Angelini A, Castellotti B, Lederer D, Benoit V, Raviglione F, Guerrini R, Dilena R, Cilio MR
Neurology 2023 Mar 21;100(12):e1234-e1247. Epub 2023 Jan 4 doi: 10.1212/WNL.0000000000206755. PMID: 36599696Free PMC Article
Ben Mohamed D, Zouari R, Ketata J, Nabli F, Blel S, Ben Sassi S
Seizure 2023 Jan;104:12-14. Epub 2022 Nov 22 doi: 10.1016/j.seizure.2022.11.010. PMID: 36446232Free PMC Article
Ferraroli E, Perulli M, Veredice C, Contaldo I, Quintiliani M, Ricci M, Venezia I, Citrigno L, Qualtieri A, Spadafora P, Cavalcanti F, Battaglia DI
Pediatr Neurol 2022 Jul;132:45-49. Epub 2022 May 17 doi: 10.1016/j.pediatrneurol.2022.05.002. PMID: 35636282
Simard C, Vogrig A, Joubert B, Muñiz-Castrillo S, Picard G, Rogemond V, Ducray F, Berzero G, Psimaras D, Antoine JC, Desestret V, Honnorat J
Neurol Neuroimmunol Neuroinflamm 2020 May;7(3) Epub 2020 Mar 13 doi: 10.1212/NXI.0000000000000699. PMID: 32170042Free PMC Article
Schaefer N, Langlhofer G, Kluck CJ, Villmann C
Br J Pharmacol 2013 Nov;170(5):933-52. doi: 10.1111/bph.12335. PMID: 23941355Free PMC Article

Recent systematic reviews

Ferraroli E, Perulli M, Veredice C, Contaldo I, Quintiliani M, Ricci M, Venezia I, Citrigno L, Qualtieri A, Spadafora P, Cavalcanti F, Battaglia DI
Pediatr Neurol 2022 Jul;132:45-49. Epub 2022 May 17 doi: 10.1016/j.pediatrneurol.2022.05.002. PMID: 35636282
Simard C, Vogrig A, Joubert B, Muñiz-Castrillo S, Picard G, Rogemond V, Ducray F, Berzero G, Psimaras D, Antoine JC, Desestret V, Honnorat J
Neurol Neuroimmunol Neuroinflamm 2020 May;7(3) Epub 2020 Mar 13 doi: 10.1212/NXI.0000000000000699. PMID: 32170042Free PMC Article

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