Table 4.

Treatment of Manifestations in Individuals with ASXL3-Related Disorder

Manifestation/
Concern
TreatmentConsiderations/Other
DD/ID See Developmental Delay / Intellectual Disability Management Issues.
Poor weight gain /
Failure to thrive
Feeding therapy; gastrostomy tube placement may be required for persistent feeding issues.Low threshold for clinical feeding eval &/or radiographic swallowing study if clinical signs or symptoms of dysphagia
GERD Anti-reflux medication; fundoplication or percutaneous endoscopic gastrostomy in severe situationsConsider consultation w/gastroenterology specialist in those w/severe disease.
Epilepsy Standardized treatment w/ASM by experienced neurologist
  • Many ASMs may be effective; none has been demonstrated effective specifically for this disorder.
  • Education of parents/caregivers 1
Pes planus, joint
contractures,
scoliosis
Standard treatment per orthopedist
Sleep apnea Standard treatment per ENT / sleep specialist
Malocclusion
&/or hypodontia
Standard treatment per dentist/orthodontist
Strabismus &/or
refractive error
Standard treatment per ophthalmologist
Family/
Community
  • Ensure appropriate social work involvement to connect families w/local resources, respite, & support.
  • Coordinate care to manage multiple subspecialty appointments, equipment, medications, & supplies.
  • Ongoing assessment of need for palliative care involvement &/or home nursing
  • Consider involvement in adaptive sports or Special Olympics.

ASM = anti-seizure medication; DD = developmental delay; GERD = gastroesophageal reflux disease; ID = intellectual disability; OT = occupational therapy; PT = physical therapy

1.

Education of parents/caregivers regarding common seizure presentations is appropriate. For information on non-medical interventions and coping strategies for children diagnosed with epilepsy, see Epilepsy Foundation Toolbox.

From: ASXL3-Related Disorder

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