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Living with Paraplegia-intellectual disability-hyperkeratosis syndrome

A rare X-linked condition with intellectual disability, slowly worsening leg stiffness, and thick skin on the palms and soles.

Understanding Paraplegia-intellectual disability-hyperkeratosis syndrome

Paraplegia-intellectual disability-hyperkeratosis syndrome is a rare X-linked condition that affects thinking, movement, and skin.

People have intellectual disability of varying severity, leg stiffness (spasticity) that slowly gets worse, and thick skin on the palms and soles. Some also have high-arched feet, hand tremor, and mild facial differences. Signs begin in infancy.

Signs & symptoms

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

  • Intellectual disability
  • Stiff, spastic legs (spastic paraplegia)
  • Thick skin on palms and soles
  • Brisk reflexes
  • Double-jointed (flexible) joints
  • Sparse scalp hair

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. Ask which tests can help

    Your care team will decide which exams and tests can confirm the diagnosis.

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 rare disease patient organizations for support
  • 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
What therapies can help with leg stiffness and walking?
What learning supports are available?
What does X-linked inheritance mean for our family?

Quick facts

Symptoms usually startInfant
InheritanceX-Linked

Changes in the genes (also called variants) cause this condition. It is X-linked, which means the gene involved is on the X chromosome. GARD doesn't list a specific gene.

GeneticNeurological

Also known as: fitzsimmons mclachlan gilbert syndrome; fitzsimmons-mclachlan-gilbert syndrome; spastic paraplegia, intellectual disability, palmoplantar hyperkeratosis syndrome

Patient organizations

Rare-disease groups that can help

Source: NIH GARD · Paraplegia-intellectual disability-hyperkeratosis syndromeGARD ID 2344 · 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 Paraplegia-intellectual disability-hyperkeratosis syndrome.

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  • Eligibility is confirmed by the study team

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