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Living with X-linked intellectual disability-psychosis-macroorchidism syndrome

A condition with intellectual disability, mental health conditions such as bipolar disorder, movement problems, and large testes in males.

Understanding X-linked intellectual disability-psychosis-macroorchidism syndrome

PPM-X syndrome is a condition with psychotic disorders, parkinsonism (movement problems), and mild to severe intellectual disability.

The most common psychotic disorder is bipolar disorder. Other symptoms may include muscle stiffness, strong reflexes, a small head, and large testes in males. Not everyone has every symptom, but most have intellectual disability. Males are typically more affected than females, who usually have mild intellectual disability or learning disabilities.

Signs & symptoms

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

  • Intellectual disability
  • Bipolar disorder
  • Hyperactivity and irritability
  • Muscle stiffness in the legs
  • Tremor
  • Seizures

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 MECP2 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 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
Could MECP2 genetic testing confirm the diagnosis?
Which specialists can help with mood and behavior?
How are movement symptoms managed?

Quick facts

Symptoms usually startChild
InheritanceX-Linked
GenesMECP2

PPM-X syndrome is caused by changes in the MECP2 gene and is inherited in an X-linked way.

GeneticNeurological

Also known as: intellectual developmental disorder, x-linked, syndromic 13; intellectual developmental disorder, x-linked, syndromic 13, x-linked recessive; intellectual disability with psychosis, pyramidal signs, and macroorchidism; intellectual disability, x-linked, syndromic 13; intellectual disability, x-linked, syndromic type 13; lindsay burn syndrome

Patient organizations

Rare-disease groups that can help

Source: NIH GARD · X-linked intellectual disability-psychosis-macroorchidism syndromeGARD ID 3506 · 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 X-linked intellectual disability-psychosis-macroorchidism syndrome.

Explore the X-linked intellectual disability-psychosis-macroorchidism syndrome blog

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  • Eligibility is confirmed by the study team

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