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- $Unique_ID{BRK03754}
- $Pretitle{}
- $Title{Freeman-Sheldon Syndrome}
- $Subject{Freeman-Sheldon Syndrome Whistling Face Syndrome Whistling
- Face-Windmill Vane Hand Syndrome Craniocarpotarsal Dystrophy FSS
- Arthrogryposis Multiplex Congenita}
- $Volume{}
- $Log{}
-
- Copyright (C) 1988, 1989, 1992 National Organization for Rare Disorders,
- Inc.
-
- 442:
- Freeman-Sheldon Syndrome
-
- ** IMPORTANT **
- It is possible the main title of the article (Freeman-Sheldon Syndrome)
- is not the name you expected. Please check the SYNONYMS listing on the next
- page to find alternate names, disorder subdivisions, and related disorders
- covered by this article.
-
- Synonyms
-
- Whistling Face Syndrome
- Whistling Face-Windmill Vane Hand Syndrome
- Craniocarpotarsal Dystrophy
- FSS
-
- Information on the following disease can be found in the Related
- Disorders section of this report:
-
- Arthrogryposis Multiplex Congenita
-
- General Discussion
-
- ** REMINDER **
- The information contained in the Rare Disease Database is provided for
- educational purposes only. It should not be used for diagnostic or treatment
- purposes. If you wish to obtain more information about this disorder, please
- contact your personal physician and/or the agencies listed in the "Resources
- section of this report.
-
-
- Freeman-Sheldon Syndrome is a very rare genetic disorder characterized by
- abnormal muscle and skeletal development and is present at birth. The face,
- eyes, hands, and feet are most commonly affected. Intelligence is often
- within the normal range although some mental deficiency may occur.
-
- Symptoms
-
- Freeman-Sheldon Syndrome patients are affected by stiffened muscles. Other
- symptoms include a round forehead, a flat, expressionless face, full cheeks,
- and a small mouth giving a "whistling" appearance. The nose appears small
- with flared nostrils, and a broadened bridge with abnormal skin folds present
- on each side. Eyes are deep-set, may not be focused in the same direction,
- and tend to squint. The distance between the upper lip and the nose may be
- abnormally long. An "H" shaped dimple can appear on the chin. The tongue is
- small, the roof of the mouth is high, and speech is nasal sounding. During
- infancy, vomiting and swallowing difficulties may result in failure to
- thrive.
-
- The second through fifth fingers are permanently bent toward contracted
- thumbs, and the skin is thickened over the first finger. Clubfeet with
- contracted toes and an open or unfused spine (Spina Bifida) may also occur.
- (For more information on this disorder, choose "Spina Bifida" as your search
- term in the Rare Disease Database). These deformities can limit usage of
- involved hands and/or feet. Intelligence is usually normal although some
- mental deficiency may develop. Abnormalities in the interior bone structure
- of the skull are often present. In males, a hernia in the genital area
- (inguinal) or undescended testes may also be present. Ridges across the
- lower forehead, small stature, low birth weight, curvature of the spine
- (scoliosis) or dislocation of the hip may also occur in some children with
- Freeman-Sheldon Syndrome.
-
- Causes
-
- Freeman-Sheldon Syndrome is inherited as an autosomal dominant trait. (Human
- traits including the classic genetic diseases, are the product of the
- interaction of two genes for that condition, one received from the father and
- one from the mother. In dominant disorders, a single copy of the disease
- gene (received from either the mother or father) will be expressed
- "dominating" the normal gene and resulting in appearance of the disease. The
- risk of transmitting the disorder from affected parent to offspring is 50%
- for each pregnancy regardless of the sex of the resulting child.)
-
- Affected Population
-
- Approximately thirty-six cases of Freeman-Sheldon Syndrome have been
- identified in the medical literature worldwide since it was first recognized
- in 1938 by two English physicians, Drs. Freeman and Sheldon. The disorder
- affects males and females in equal numbers.
-
- Related Disorders
-
- Symptoms of the following disorder can be similar to those of Freeman-Sheldon
- Syndrome. Comparisons may be useful for a differential diagnosis:
-
- Arthrogryposis Multiplex Congenita is a congenital disease characterized
- by reduced mobility of multiple joints at birth due to proliferation of
- fibrous tissue (fibrous ankylosis). The range of motion of all joints is
- limited or fixed. Shoulders are bent inward and internally rotated, the
- elbows are extended, and the wrists and fingers are bent. The hips may be
- dislocated and are usually slightly bent, the knees are extended, and the
- heel is bent inward from the midline of the leg while the foot is bent inward
- at the ankle (clubfoot). Intelligence is usually normal and lack of facial
- expression gives a sad appearance. (For more information on this disorder,
- choose "Arthrogryposis" as your search term in the Rare Disease Database).
-
- Therapies: Standard
-
- Treatment of Freeman-Sheldon Syndrome usually involves multiple surgeries
- which can be difficult due to muscle stiffness, thickened tissues or the use
- of splints or casts to improve bent fingers or feet. Cosmetic facial or
- hand/foot restructuring surgery can improve appearance. Correction of the
- thumb deformity may be the first surgery in the long-term treatment of many
- cases. Genetic counseling will be of benefit for patients and their
- families. Other treatment is symptomatic and supportive.
-
- Therapies: Investigational
-
- Several Freeman-Sheldon Syndrome (FSS) patients with a family history of
- Malignant Hyperthermia have developed spasms of the muscles that affect jaw
- movement as well as generalized muscle rigidity after the administration of
- anesthesia with known Malignant Hyperthermia triggering agents (halothane and
- succinylcholine). It has been suggested that non-triggering Malignant
- Hyperthermia agents should be considered for all patients with FSS.
-
- The University of Virginia Department of Plastic Surgery is reviewing
- surgical procedures for FSS. The address is:
-
- Craniofacial Abnormalities
- Dept. of Plastic and Maxillofacial Surgery
- University of Virginia Medical Center
- Box 376
- Charlottesville, VA 22908
- (804) 924-5801
-
- The University of Utah Division of Pediatric Genetics has undertaken a
- gene mapping study of FSS. The address is:
-
- Freeman-Sheldon Gene Mapping Project
- Division of Pediatric Genetics
- MREB 413
- University of Utah Medical Center
- Salt Lake City, UT 84112
- (801) 581-8943
-
- This disease entry is based upon medical information available through
- November 1992. Since NORD's resources are limited, it is not possible to
- keep every entry in the Rare Disease Database completely current and
- accurate. Please check with the agencies listed in the Resources section for
- the most current information about this disorder.
-
- Resources
-
- For more information on Freeman-Sheldon Syndrome, please contact:
-
- National Organization for Rare Disorders (NORD)
- P.O. Box 8923
- New Fairfield, CT 06812-1783
- (203) 746-6518
-
- Freeman-Sheldon Parent Support Group
- 509 E. Northmont Way
- Salt Lake City, UT 84103
- (801) 364-7060
-
- The National Arthritis and Musculoskeletal and Skin Diseases Information
- Clearinghouse
- Box AMS
- Bethesda, MD 20892
- (301) 495-4484
-
- For genetic information, and genetic counseling referrals, please
- contact:
-
- March of Dimes Birth Defects Foundation
- 1275 Mamaroneck Avenue
- White Plains, NY 10605
- (914) 428-7100
-
- Alliance of Genetic Support Groups
- 35 Wisconsin Circle, Suite 440
- Chevy Chase, MD 20815
- (800) 336-GENE
- (301) 652-5553
-
- References
-
- OCULAR ABNORMALITIES IN THE FREEMAN-SHELDON SYNDROME: M. O'Keefe, et al.; Am
- J Ophthalmol (September 1986, issue 102(3)). Pp. 346-348.
-
- NEW EVIDENCE FOR GENETIC HETEROGENEITY OF THE FREEMAN-SHELDON (FS)
- SYNDROME: M. Sanchez, et al.; Am J Med Genet (November 1986, issue 25(3)).
- Pp. 507-511.
-
- FREEMAN-SHELDON SYNDROME: A DISORDER OF CONGENITAL MYOPATHIC ORIGIN? :
- J. Vanek, et al.; J Med Genet (June 1986, issue 23(3)). Pp. 231-236.
-
- MUSCLE RIGIDITY FOLLOWING HALOTHANE ANESTHESIA IN TWO PATIENTS WITH
- FREEMAN-SHELDON SYNDROME: Roger Jones, M.D., et al.; Anesthesiology
- (September 1992, issue 77(3)). Pp. 599-600.
-
-