Sjögren-Larsson Syndrome (SLS) is a rare, autosomal-inherited, cerebral palsy disorder
that is characterized by dry, scaly skin (ichthyosis), neurological problems (spastic
diplegia, usually involving the legs, or tetraplegia), eye problems, varying degrees
of intellectual disability and developmental delay. (SLS should not be confused with Sjögren syndrome, which is a different disorder.)
At birth, the skin is red (erythematous), but later in infancy the skin becomes dry,
rough, and scaly with a brownish or yellowish tone. Mild to severe itchiness (pruritus)
is also common. These skin abnormalities are generally dispersed over the whole body,
most severely affecting the nape of the neck, the torso, and the extremities. The
skin of the face is usually not affected.
People with this condition may have additional neurological signs and symptoms due
to leukoencephalopathy, which is a disorder of white matter of the brain thought to
contribute to many of the neurological signs and symptoms in people with SLS. Most
affected individuals have intellectual disability that varies from mild to profound
and is usually apparent by early childhood.
Other neurologic findings include speech difficulties (dysarthria) and delayed speech.
Usually people with SLS are able to produce only short sentences with poorly formed
words. In addition, approximately 40 percent of people with SLS have seizures.
DIAGNOSTIC TESTING, PHYSICAL FINDINGS, AND ICD-9-CM CODING
Diagnostic testing: The diagnosis of SLS is confirmed by genetic testing for mutations in the ALDH3A2
Physical findings: Developmental delay, including intellectual disability; delayed speech; delayed
motor development; abnormal muscle stiffness (spasticity); seizures; glistening white
dots at the back of the eye (retina); ichthyosis ; and nearsightedness (myopia).
ONSET AND PROGRESSION
Developmental delays usually become apparent during the first 2 years of life. Spasticity
is almost always present by age 2 years. Seizures typically develop later in childhood.
No progression of the intellectual deficit occurs after puberty and any developmental
skills, once gained, are usually maintained over time. However, if contractures progress,
individuals may lose the ability to walk. About one-half of people with SLS require
wheelchair assistance and many others need some form of support to walk.
Individuals with SLS usually survive well into adulthood but require life-long care.
Life expectancy is determined by the severity of neurologic disorders. Morbidity is
associated with chronic neurologic disease and lifelong ichthyosis.