U.S. flag

An official website of the United States government

Format

Send to:

Choose Destination

Hyperekplexia

MedGen UID:
488800
Concept ID:
C0234166
Sign or Symptom
Synonym: Hyperekplexias
SNOMED CT: Hyperekplexia (19557000); Startle syndrome (19557000); Hyperexplexia (19557000)
 
Related genes: ATAD1, ARHGEF9, GPHN, SLC6A5, GLRB, GLRA1
 
Monarch Initiative: MONDO:0017658
Orphanet: ORPHA306773

Definition

Hereditary hyperekplexia is a condition in which affected infants have increased muscle tone (hypertonia) and an exaggerated startle reaction to unexpected stimuli, especially loud noises. Following the startle reaction, infants experience a brief period in which they are very rigid and unable to move. During these rigid periods, some infants stop breathing, which, if prolonged, can be fatal. Infants with hereditary hyperekplexia have hypertonia at all times, except when they are sleeping.

Other signs and symptoms of hereditary hyperekplexia can include muscle twitches when falling asleep (hypnagogic myoclonus) and movements of the arms or legs while asleep. Some infants, when tapped on the nose, extend their head forward and have spasms of the limb and neck muscles. Rarely, infants with hereditary hyperekplexia experience recurrent seizures (epilepsy).

The signs and symptoms of hereditary hyperekplexia typically fade by age 1. However, older individuals with hereditary hyperekplexia may still startle easily and have periods of rigidity, which can cause them to fall down. They may also continue to have hypnagogic myoclonus or movements during sleep. As they get older, individuals with this condition may have a low tolerance for crowded places and loud noises. People with hereditary hyperekplexia who have epilepsy have the seizure disorder throughout their lives.

Hereditary hyperekplexia may explain some cases of sudden infant death syndrome (SIDS), which is a major cause of unexplained death in babies younger than 1 year. [from MedlinePlus Genetics]

Professional guidelines

PubMed

Li EC, Zhang TY, Cai MT, Su SY, Shen CH, Lai QL, Zhang YX
Neurol Neuroimmunol Neuroinflamm 2025 Mar;12(2):e200350. Epub 2024 Dec 18 doi: 10.1212/NXI.0000000000200350. PMID: 39693598Free PMC Article
Falsaperla R, Sortino V, Giacchi V, Saporito MAN, Marino S, Tardino LG, Marino L, Gennaro A, Ruggieri M, Barberi C, Polizzi A
J Child Neurol 2024 Oct;39(11-12):415-424. Epub 2024 Sep 2 doi: 10.1177/08830738241273425. PMID: 39223854
Cross JH
Semin Fetal Neonatal Med 2013 Aug;18(4):192-5. Epub 2013 Apr 30 doi: 10.1016/j.siny.2013.04.003. PMID: 23642846

Recent clinical studies

Etiology

Battaglia DI, Gambardella ML, Veltri S, Contaldo I, Chillemi G, Veredice C, Quintiliani M, Leoni C, Onesimo R, Verdolotti T, Radio FC, Martinelli D, Trivisano M, Specchio N, Dravet C, Tartaglia M, Zampino G
Genes (Basel) 2021 Aug 26;12(9) doi: 10.3390/genes12091316. PMID: 34573299Free PMC Article
Zhan FX, Wang SG, Cao L
Neurol Sci 2021 Oct;42(10):4095-4107. Epub 2021 Aug 11 doi: 10.1007/s10072-021-05493-8. PMID: 34379238
Balint B, Vincent A, Meinck HM, Irani SR, Bhatia KP
Brain 2018 Jan 1;141(1):13-36. doi: 10.1093/brain/awx189. PMID: 29053777Free PMC Article
Bhidayasiri R, Truong DD
Handb Clin Neurol 2011;100:421-30. doi: 10.1016/B978-0-444-52014-2.00032-X. PMID: 21496599
Bakker MJ, van Dijk JG, van den Maagdenberg AM, Tijssen MA
Lancet Neurol 2006 Jun;5(6):513-24. doi: 10.1016/S1474-4422(06)70470-7. PMID: 16713923

Diagnosis

Yayıcı Köken Ö, Toptaş Dedeoğlu Ö, Aksoy A, Yüksel D
Neurol Neurochir Pol 2020;54(5):473-474. Epub 2020 Jul 24 doi: 10.5603/PJNNS.a2020.0057. PMID: 32706098
Orivoli S, Facini C, Pisani F
Brain Dev 2015 Oct;37(9):833-9. Epub 2015 Feb 14 doi: 10.1016/j.braindev.2015.01.002. PMID: 25687201
Hallett M, Rothwell J
Mov Disord 2011 May;26(6):958-67. doi: 10.1002/mds.23572. PMID: 21626542Free PMC Article
Bakker MJ, van Dijk JG, van den Maagdenberg AM, Tijssen MA
Lancet Neurol 2006 Jun;5(6):513-24. doi: 10.1016/S1474-4422(06)70470-7. PMID: 16713923
Brown P
Curr Opin Neurol 1996 Aug;9(4):314-6. doi: 10.1097/00019052-199608000-00013. PMID: 8858191

Therapy

Fatima H, Shabnam S, Tripathi S, Kumar M
BMJ Case Rep 2024 Oct 15;17(10) doi: 10.1136/bcr-2023-257260. PMID: 39414323
McAbee GN
J Child Neurol 2015 Jan;30(1):91-2. Epub 2014 Jan 21 doi: 10.1177/0883073813516677. PMID: 24453146
Espay AJ, Chen R
Continuum (Minneap Minn) 2013 Oct;19(5 Movement Disorders):1264-86. doi: 10.1212/01.CON.0000436156.54532.1a. PMID: 24092290
Hamelin S, Rohr P, Kahane P, Minotti L, Vercueil L
Epileptic Disord 2004 Sep;6(3):169-72. PMID: 15504715
Breitinger HG, Becker CM
Neurosci Lett 2002 Oct 4;331(1):21-4. doi: 10.1016/s0304-3940(02)00773-5. PMID: 12359314

Prognosis

Ferraroli E, Perulli M, Veredice C, Contaldo I, Quintiliani M, Ricci M, Venezia I, Citrigno L, Qualtieri A, Spadafora P, Cavalcanti F, Battaglia DI
Pediatr Neurol 2022 Jul;132:45-49. Epub 2022 May 17 doi: 10.1016/j.pediatrneurol.2022.05.002. PMID: 35636282
Wu Z, Lape R, Jopp-Saile L, O'Callaghan BJ, Greiner T, Sivilotti LG
J Physiol 2020 Aug;598(16):3417-3438. Epub 2020 Jun 18 doi: 10.1113/JP279803. PMID: 32445491Free PMC Article
Thomas RH, Drew CJ, Wood SE, Hammond CL, Chung SK, Rees MI
J Neurol Neurosurg Psychiatry 2015 Mar;86(3):341-3. Epub 2014 Jun 26 doi: 10.1136/jnnp-2014-307903. PMID: 24970905
Sharma SD, Sarna A, Mukhopadhyay S
Indian Pediatr 2006 Jun;43(6):539-41. PMID: 16820664
Breitinger HG, Villmann C, Becker K, Becker CM
J Biol Chem 2001 Aug 10;276(32):29657-63. Epub 2001 Jun 6 doi: 10.1074/jbc.M100446200. PMID: 11395484

Clinical prediction guides

Ferraroli E, Perulli M, Veredice C, Contaldo I, Quintiliani M, Ricci M, Venezia I, Citrigno L, Qualtieri A, Spadafora P, Cavalcanti F, Battaglia DI
Pediatr Neurol 2022 Jul;132:45-49. Epub 2022 May 17 doi: 10.1016/j.pediatrneurol.2022.05.002. PMID: 35636282
Battaglia DI, Gambardella ML, Veltri S, Contaldo I, Chillemi G, Veredice C, Quintiliani M, Leoni C, Onesimo R, Verdolotti T, Radio FC, Martinelli D, Trivisano M, Specchio N, Dravet C, Tartaglia M, Zampino G
Genes (Basel) 2021 Aug 26;12(9) doi: 10.3390/genes12091316. PMID: 34573299Free PMC Article
Equiza J, Rodríguez-Antigüedad J, Campo-Caballero D, Iruzubieta P, Prada Á, Roncancio A, Fernández E, Ganzarain Oyarbide M, Arruti M, Urtasun MA, Castillo-Triviño T
J Neuroimmunol 2021 Oct 15;359:577695. Epub 2021 Aug 14 doi: 10.1016/j.jneuroim.2021.577695. PMID: 34416409
Thomas RH, Drew CJ, Wood SE, Hammond CL, Chung SK, Rees MI
J Neurol Neurosurg Psychiatry 2015 Mar;86(3):341-3. Epub 2014 Jun 26 doi: 10.1136/jnnp-2014-307903. PMID: 24970905
Breitinger HG, Villmann C, Becker K, Becker CM
J Biol Chem 2001 Aug 10;276(32):29657-63. Epub 2001 Jun 6 doi: 10.1074/jbc.M100446200. PMID: 11395484

Recent systematic reviews

Li EC, Zhang TY, Cai MT, Su SY, Shen CH, Lai QL, Zhang YX
Neurol Neuroimmunol Neuroinflamm 2025 Mar;12(2):e200350. Epub 2024 Dec 18 doi: 10.1212/NXI.0000000000200350. PMID: 39693598Free PMC Article
Falsaperla R, Sortino V, Giacchi V, Saporito MAN, Marino S, Tardino LG, Marino L, Gennaro A, Ruggieri M, Barberi C, Polizzi A
J Child Neurol 2024 Oct;39(11-12):415-424. Epub 2024 Sep 2 doi: 10.1177/08830738241273425. PMID: 39223854
Ferraroli E, Perulli M, Veredice C, Contaldo I, Quintiliani M, Ricci M, Venezia I, Citrigno L, Qualtieri A, Spadafora P, Cavalcanti F, Battaglia DI
Pediatr Neurol 2022 Jul;132:45-49. Epub 2022 May 17 doi: 10.1016/j.pediatrneurol.2022.05.002. PMID: 35636282
Simard C, Vogrig A, Joubert B, Muñiz-Castrillo S, Picard G, Rogemond V, Ducray F, Berzero G, Psimaras D, Antoine JC, Desestret V, Honnorat J
Neurol Neuroimmunol Neuroinflamm 2020 May;7(3) Epub 2020 Mar 13 doi: 10.1212/NXI.0000000000000699. PMID: 32170042Free PMC Article

Supplemental Content

Table of contents

    Clinical resources

    Practice guidelines

    • PubMed
      See practice and clinical guidelines in PubMed. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.
    • Bookshelf
      See practice and clinical guidelines in NCBI Bookshelf. The search results may include broader topics and may not capture all published guidelines. See the FAQ for details.

    Recent activity

    Your browsing activity is empty.

    Activity recording is turned off.

    Turn recording back on

    See more...