Table 1.
Requirement for classic or typical RTT | A period of regression followed by stabilization and recovery: 1. All main and all exclusion criteria 2. Supportive criteria not required although may be present |
Requirement for variant or atypical RTT | 1. A period of regression followed by stabilization and recovery 2. At least 2 of 4 main criteria and 5 of 11 supportive criteria |
Main criteria | 1. Partial or complete loss of acquired purposeful hand skills 2. Partial or complete loss of spoken language 3. Dyspraxic gait or inability to ambulate 4. Stereotypic hand movements: hand mouthing, hand wringing/clasping, hand clapping, or finger rubbing |
Exclusion criteria | 1. Brain injury: peri- or postnatal trauma, neurometabolic disease, or severe infection involving neurological function 2. Grossly abnormal psychomotor development in first 6 months after birth |
Supportive criteria for variant RTT | 1. Periodic breathing during wakefulness 2. Bruxism while awake 3. Altered sleep pattern 4. Abnormal muscle tone 5. Peripheral vasomotor disturbance 6. Scoliosis/kyphosis 7. Growth failure 8. Small cool/cold hands and/or feet 9. Inappropriate laughing or screaming spells 10. Delayed or diminished response to pain 11. Intense eye communication or “eye pointing” |