NICOLADES-BARAITSER SYNDROME
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ALTERNATE NAMES
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Intellectual Disability-Sparse Hair-Brachydactyly Syndrome; NBS; NCBRS; Sparse Hair
and Mental Retardation
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DESCRIPTION
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Nicolaides-Baraitser syndrome (NCBRS) is a very rare condition characterized by severe intellectual disability and various
physical features. Features of the condition can worsen over time. NCBRS is caused
by mutations in the SMARCA2 gene and is inherited in an autosomal dominant manner. However, all cases of NCBRS
reported to date have been sporadic, occurring in people with no family history of
NCBRS.
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DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM/ICD-10-CM CODING
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Diagnostic testing: Genetic testing showing mutations in the SMARCA2 gene.
Physical findings:
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Nose with a broad base, thick nostrils, and upturned tip;
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Broad philtrum (indentation in middle of upper lip);
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Narrow and or down-slanting palpebral fissures (width of the eyes);
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Short fingers and toes (brachydactyly); and
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Prominent joints of the fingers and toes (interphalangeal joints).
ICD-9: 758.5
ICD-10: Q87.1
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PROGRESSION
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Most individuals with NCBRS have epilepsy, which often begins in infancy. Affected
individuals can experience multiple seizure types, and the seizures can be difficult
to control with medication.
All individuals with NCBRS have moderate to severe intellectual disability. Early
developmental milestones, such as crawling and walking, are often normally achieved,
but further development is limited, and language development is severely impaired.
At least one-third of affected individuals never develop speech, while others lose
their verbal communication over time. People with this condition are often described
as having a happy demeanor and being very friendly, although they can exhibit moments
of aggression and temper tantrums.
While some features of NCBRS are always present, there is variability, and the severity
of features may range from mild to severe. Therefore, the long-term outlook may vary
among affected people.
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TREATMENT
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Treatment of NCBRS focuses on managing individual symptoms. Depending on the symptoms
present, treatment might include medication, occupational therapy, physical therapy,
speech therapy, and hearing aids. Seizures are treated with anti-convulsant medications.
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SUGGESTED PROGRAMMATIC ASSESSMENT*
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Suggested MER for Evaluation:
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Clinical history and examination that describes diagnostic features of the impairment;
and
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Genetic testing showing mutations in the SMARCA2 gene.
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Suggested Listings for Evaluation:
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DETERMINATION
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LISTING
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REMARKS
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Meets
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110.08 B
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111.02
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111.09
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112.05
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112.14
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Equals
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* Adjudicators may, at their discretion, use the Medical Evidence of Record or the
listings suggested to evaluate the claim. However, the decision to allow or deny the
claim rests with the adjudicator.
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