The initial observations that leads a physician to suspect a fat digestion problem is that affected babies have severe stomach problems with a high level of fats detected in the stool; the stool is often pale and foul smelling. One of the first medical tests usually performed on infants with failure to thrive is a complete blood count (CBC), which shows abnormal, thorny-shaped red blood cells (acanthocytes) that can be visualized using a microscope. A lipid profile demonstrates low levels of total cholesterol and low concentrations of VLDL and LDL in the blood. Apolipoprotein B can be completely absent or detected in reduced amounts in the blood. Due to the inability to digest fats, loss of fat-soluble vitamins such as vitamin A, D, E, or K occurs and can result in a deficiency. An examination by an ophthalmologist might show retinal degeneration leading to visual loss. A neurologist might find nerve demyelination (degeneration of the protective layer of the nerve) by performing nerve conduction studies or an EMG. Loss of peripheral nerves can be associated with ataxia (abnormal muscle coordination).
In addition to consistent evaluation by an experienced neurologist, it is important to consult with a nutritionist regarding the appropriate dietary restriction, as this can influence the development and well being of an affected individual. There is also a requirement for large doses of fat-soluble vitamin supplements because there is an inability to digest fat from the diet; the body does not retain these vitamins. Because the child with Bassen-Kornzweig syndrome often suffers from hypotonia and ataxia, an experienced physical therapist can often help develop strategies to treat the associated symptoms.
Persons with Bassen-Kornzweig syndrome are treated primarily to lessen symptoms. The most formidable approach to treatment is dietary restriction and supplementation with the appropriate vitamins (D, E, A, and K) as well as with fats that can be broken down more easily. Supplementation with fat-soluble vitamins may slow the progression of the retinal degeneration. As these patients can develop movement disorders such as tremors, chorea (uncontrollable shaking), difficulty talking (dysarthria), and difficulty with tasks that require coordination, speech and occupational therapy is recommended and can be helpful.
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Author Info: Bryan Richard Cobb PhD, The Gale Group Inc., Gale, Detroit, Gale Encyclopedia of Neurological Disorders, 2005 |