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Living with Hartsfield-Bixler-Demyer syndrome

A rare condition with a brain development difference (holoprosencephaly) and a split-hand or split-foot difference (ectrodactyly).

Understanding Hartsfield-Bixler-Demyer syndrome

Hartsfield syndrome is a rare condition with holoprosencephaly, a brain development difference, and ectrodactyly, a hand and foot difference.

Holoprosencephaly happens when the brain doesn't divide properly into right and left halves before birth, and severity ranges from mild to severe. People often have other brain differences, including those that affect hormones that direct sexual development, and these can cause seizures, feeding difficulties, and trouble regulating temperature and sleep. Development is delayed, from mild to severe. Ectrodactyly is a deep split in the hand or foot. It begins during pregnancy.

Signs & symptoms

Symptoms vary from person to person. GARD lists these among the most common:

  • Brain development difference (holoprosencephaly)
  • Split hand or foot (ectrodactyly)
  • Cleft palate
  • Delayed development
  • Small eyes and drooping eyelids
  • Early closing of skull joints (craniosynostosis)

Not everyone has every symptom. GARD's list comes from the Human Phenotype Ontology.

Diagnosis

  1. Talk with your doctor

    Share the symptoms you've noticed, when they started and your family health history. Notes and photos can help.

  2. See a specialist

    Specialists who may be involved include bone and joint specialists, brain and nervous system specialists, ear, nose, and throat specialists and genetic specialists.

  3. Consider genetic testing

    Changes in FGFR1 are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

  4. Connect with expert centers

    World Craniofacial Foundation may keep lists of experts for this condition.

Care & treatment

Care team
Bone and joint specialists (orthopedists or orthopedic surgeons); Brain and nervous system specialists (neurologists); Ear, nose, and throat specialists (otolaryngologists); Genetic specialists (geneticists)
Expert care
Expert lists: World Craniofacial Foundation
Treatment
GARD doesn't list specific treatments for this condition. Your care team will tailor care to your symptoms.
Research
Clinical trials and observational studies may be options. See the research section below.

General information, not medical advice. Your care team makes the decisions.

Everyday life

Living with a rare condition is easier with support.

  • Connect with The Carter Centers for Brain Research in Holoprosencephaly and Related Malformations and other patient organizations
  • Keep notes on symptoms, changes and questions for appointments
  • Ask about patient registries that help research
  • Look into financial aid and travel resources for care visits
Bring these questions to your next doctor visit
Can genetic testing confirm a change in the FGFR1 gene?
Which hormone tests are needed, given brain differences?
What can help with seizures, feeding, and development?

Quick facts

Symptoms usually startduring Pregnancy
InheritanceAutosomal Dominant, Autosomal Recessive
GenesFGFR1

Changes in the FGFR1 gene cause this condition. GARD lists both autosomal dominant and autosomal recessive inheritance.

GeneticNeurological

Also known as: hartsfield bixler demyer syndrome; hartsfield syndrome; holoprosencephaly-ectrodactyly-cleft lip palate syndrome; holoprosencephaly-ectrodactyly-cleft lip/palate syndrome; holoprosencephaly, ectrodactyly, and bilateral cleft lip/palate; holoprosencephaly, ectrodactyly, cleft lip, cleft palate syndrome

Patient organizations

Source: NIH GARD · Hartsfield-Bixler-Demyer syndromeGARD ID 2725 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

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