Administration of SAMe to adult LNS patients was shown to provide improvement in neurobehavioural and other neurological attributes. The drug is available without prescription and has been widely used for depression, but its use for treating LNS should be undertaken only under strict medical supervision, as side effects are known. Prognosis
The prognosis for individuals with severe LNS is poor. Death is usually due to kidney failure or complications from hypotonia, in the first or second decade of life. Less severe forms have better prognosis. History
Michael Lesch was a medical student at Johns Hopkins and William Nyhan, a pediatrician and biochemical geneticist, was his mentor when the two identified LNS and its associated hyperuricemia in two affected brothers, ages 4 and 8. Lesch and Nyhan published their findings in 1964. Within three years, the metabolic cause was identified by J. Edwin Seegmiller and his colleagues at the NIH. References
External links
Lesch-Nyhan Syndrome at NIHs Office of Rare Diseases
GeneReview/NIH/UW entry on Lesch–Nyhan syndrome
National Institute of Child Health and Human Development (NICHD)
Transmission
Poliomyelitis is highly contagious via the fecal–oral (intestinal source) and the oral–oral (oropharyngeal source) routes. In endemic areas, wild polioviruses can infect virtually the entire human population. It is seasonal in temperate climates, with peak transmission occurring in summer and autumn. These seasonal differences are far less pronounced in tropical areas. The time between first exposure and first symptoms, known as the incubation period, is usually 6 to 20 days, with a maximum range of 3 to 35 days. Virus particles are excreted in the feces for several weeks following initial infection. The disease is transmitted primarily via the fecal–oral route, by ingesting contaminated food or water. It is occasionally transmitted via the oral–oral route, a mode especially visible in areas with good sanitation and hygiene. Polio is most infectious between 7 and 10 days before and after the appearance of symptoms, but transmission is possible as long as the virus remains in the saliva or feces.Factors that increase the risk of polio infection or affect the severity of the disease include immune deficiency, malnutrition, physical activity immediately following the onset of paralysis, skeletal muscle injury due to injection of vaccines or therapeutic agents, and pregnancy. Although the virus can cross the maternal-fetal barrier during pregnancy, the fetus does not appear to be affected by either maternal infection or polio vaccination. Maternal antibodies also cross the placenta, providing passive immunity that protects the infant from polio infection during the first few months of life.