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Living with PURA-related severe neonatal hypotonia-seizures-encephalopathy syndrome due to a point mutation

A genetic condition present at birth with very low muscle tone, feeding and breathing difficulty, seizures, and developmental delay.

Understanding PURA-related severe neonatal hypotonia-seizures-encephalopathy syndrome due to a point mutation

PURA-related severe neonatal hypotonia-seizures-encephalopathy syndrome is a genetic condition present at birth, caused by a point change in the PURA gene.

Babies have very low muscle tone, which can make breathing and eating hard. Many need support such as help with breathing or feeding tubes. There are delays in development, and walking and talking ability varies. Seizures and exaggerated startle responses can occur. Some people have heart, urinary and genital, bone, or hormone issues.

Signs & symptoms

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

  • Very low muscle tone as a newborn
  • Breathing difficulty
  • Feeding difficulty in infancy
  • Delays in development
  • Seizures
  • Exaggerated startle responses

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 PURA 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

    PURA Syndrome Foundation may keep lists of experts for this condition.

Care & treatment

Care team
Brain and nervous system specialists (neurologists); Genetic specialists (geneticists)
Expert care
Expert lists: PURA Syndrome 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 PURA Syndrome Foundation
  • 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
Would genetic testing for the PURA gene help our family?
What feeding and breathing support might my child need?
How should we check the heart, hormones, and bones?

Quick facts

Symptoms usually startNewborn and as an Infant
InheritanceAutosomal Dominant
GenesPURA

This condition is caused by changes in the PURA gene. It is autosomal dominant, meaning one changed copy of the gene is enough.

GeneticNeurological

Also known as: autosomal dominant intellectual disability 31; intellectual disability, autosomal dominant type 31; mrd31; pura syndrome

Patient organizations

  • PURA Syndrome FoundationPURA-related severe neonatal hypotonia-seizures-encephalopathy syndrome due to a point mutation · United States
Source: NIH GARD · PURA-related severe neonatal hypotonia-seizures-encephalopathy syndrome due to a point mutationGARD ID 17740 · GARD page updated September 2026 · Plain-language summary by Know Rare; editorial review pending. General information, not medical advice.

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