{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,2]],"date-time":"2026-07-02T17:17:49Z","timestamp":1783012669503,"version":"3.54.6"},"reference-count":29,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T00:00:00Z","timestamp":1775174400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["American J of Med Genetics Pt A"],"published-print":{"date-parts":[[2026,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:p>\n                    Pathogenic variants in\n                    <jats:italic>RALA<\/jats:italic>\n                    cause Hiatt\u2013Neu\u2013Cooper syndrome, a rare and clinically complex neurodevelopmental condition characterized by developmental delay, hypotonia, and intellectual disability, with distinctive craniofacial features. The disease is also associated with variably occurring seizures, macrocephaly, and autism spectrum disorder. Reported manifestations have primarily involved the central nervous system, and structural spinal abnormalities have not been described to date. Here we report a child with a\n                    <jats:italic>de novo RALA<\/jats:italic>\n                    missense pathogenic variant, c.73G&gt;A (p.Val25Met), who presented with features consistent with\n                    <jats:italic>RALA<\/jats:italic>\n                    \u2010associated neurodevelopmental syndrome and subsequently developed progressive lower extremity weakness. Somatosensory evoked potentials were abnormal, and spinal MRI demonstrated spinal epidural lipomatosis. Surgical exploration confirmed tethered cord syndrome with a fatty filum terminale. The patient underwent surgical detethering, followed by marked postoperative improvement in motor function. This case expands the phenotypic spectrum of\n                    <jats:italic>RALA<\/jats:italic>\n                    \u2010associated disease to include surgically treatable lumbosacral pathology. Consideration of structural spinal abnormalities may be warranted in children with\n                    <jats:italic>RALA<\/jats:italic>\n                    \u2010related neurodevelopmental syndrome who develop new or progressive motor symptoms, as timely intervention may substantially improve functional outcomes.\n                  <\/jats:p>","DOI":"10.1002\/ajmg.a.70151","type":"journal-article","created":{"date-parts":[[2026,4,3]],"date-time":"2026-04-03T10:16:05Z","timestamp":1775211365000},"page":"1917-1922","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Tethered Cord Syndrome and Spinal Epidural Lipomatosis in a Child With\n                    <scp>\n                      <i>RALA<\/i>\n                    <\/scp>\n                    \u2010Associated Hiatt\u2013Neu\u2013Cooper Syndrome"],"prefix":"10.1002","volume":"200","author":[{"given":"Gamze","family":"Gorgulu","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Neurology University of Health Sciences Turkey, Izmir Faculty of Medicine, Dr. Behcet Uz Children's Hospital  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beyhan Berna","family":"Akpara","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Neurology University of Health Sciences Turkey, Izmir Faculty of Medicine, Dr. Behcet Uz Children's Hospital  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Edis","family":"Colak","sequence":"additional","affiliation":[{"name":"Department of Radiology University of Health Sciences Turkey, Izmir Faculty of Medicine, Dr. Behcet Uz Children's Hospital  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4449-7085","authenticated-orcid":false,"given":"Ece","family":"Onel","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Neurology University of Health Sciences Turkey, Izmir Faculty of Medicine, Dr. Behcet Uz Children's Hospital  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elif","family":"Bolat","sequence":"additional","affiliation":[{"name":"Department of Neurosurgery Ege University Medical Faculty  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5149-9310","authenticated-orcid":false,"given":"Gulcin","family":"Akinci","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Neurology University of Health Sciences Turkey, Izmir Faculty of Medicine, Dr. Behcet Uz Children's Hospital  Izmir Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2026,4,3]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/bs.ircmb.2020.10.005"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ydbio.2014.07.019"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1159\/000089503"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.21037\/jss.2019.09.02"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00330\u2010002\u20101716\u20104"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.79.16.4848"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1002\/j.1460\u20102075.1986.tb04485.x"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/nar\/17.11.4380"},{"issue":"7","key":"e_1_2_9_10_1","first-page":"1421","article-title":"Ventriculus Terminalis of the Conus Medullaris: MR Findings in Children","volume":"16","author":"Coleman L. 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