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Living with Intellectual disability, X-linked 49

A rare X-linked genetic condition (CLCN4-related) with intellectual disability, epilepsy, and behavior differences.

Understanding Intellectual disability, X-linked 49

Intellectual disability, X-linked 49 (CLCN4-related X-linked intellectual disability syndrome) is a rare genetic condition with a wide range of symptoms.

Symptoms include epilepsy, intellectual disability, and behavior differences such as autism, mood disorders, obsessive-compulsive behavior, and aggression. Neurological symptoms may continue to worsen, with movement problems and muscle stiffness. Many females with one copy of the change have few or no symptoms, but some may be severely affected.

Signs & symptoms

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

  • Intellectual disability, moderate to severe
  • Global developmental delay
  • Seizures
  • Behavior differences
  • Changes in white matter on brain scans
  • Muscle stiffness (spasticity)

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 brain and nervous system specialists and genetic specialists.

  3. Consider genetic testing

    Changes in CLCN4 are linked to this condition. Genetic testing and counseling can help confirm a diagnosis and explain what it means for your family.

Care & treatment

Care team
Brain and nervous system specialists (neurologists); Genetic specialists (geneticists)
Expert care
Ask about multidisciplinary care centers for rare conditions
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 Simons Searchlight
  • 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 for the CLCN4 gene confirm the diagnosis?
How can seizures and behavior be managed?
What does X-linked inheritance mean for female relatives?

Quick facts

Symptoms usually startInfant and as a Child
InheritanceX-Linked
GenesCLCN4

Changes in the CLCN4 gene cause this condition. It is inherited in an X-linked pattern, meaning the gene is on the X chromosome.

GeneticNeurological

Also known as: chloride voltage-gated channel 4-related x-linked intellectual disability syndrome; clcn4-related x-linked intellectual disability syndrome; intellectual disability, x-linked 15; mrx49; mrxsrc; raynaud claes syndrome

Patient organizations

Source: NIH GARD · Intellectual disability, X-linked 49GARD ID 17880 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

You are more than your diagnosis

Perspectives from people navigating life with Intellectual disability, X-linked 49.

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