National Center for Advancing and Translational Sciences Genetic and Rare Diseases Information Center, a program of the National Center for Advancing and Translational Sciences

Polyhydramnios, megalencephaly, and symptomatic epilepsy syndrome



Other Names:
PMSE Syndrome; Pretzel syndrome

Polyhydramnios, megalencephaly, and symptomatic epilepsy syndrome (PMSE syndrome) is characterized by excessive accumulation of amniotic fluid that surrounds the baby in the uterus during pregnancy (polyhydramnios), abnormally large, heavy, and usually malfunctioning brain (megalencephaly), seizures and intellectual disability. Some patients also have heart problems, diabetes insipidus, kidney problems and leukemia. It is caused by a mutation in the LYK5 gene.[1][2]  Seizures are difficult to treat and there is ongoing research for more effective medication.[3]
Last updated: 2/3/2016

This table lists symptoms that people with this disease may have. For most diseases, symptoms will vary from person to person. People with the same disease may not have all the symptoms listed. This information comes from a database called the Human Phenotype Ontology (HPO) . The HPO collects information on symptoms that have been described in medical resources. The HPO is updated regularly. Use the HPO ID to access more in-depth information about a symptom.

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Medical Terms Other Names
Learn More:
HPO ID
5%-29% of people have these symptoms
Joint laxity
Joint instability
Lax joints
Loose-jointedness
Loosejointedness
[ more ]
0001388
1%-4% of people have these symptoms
Atrial septal defect
An opening in the wall separating the top two chambers of the heart
Hole in heart wall separating two upper heart chambers
[ more ]
0001631
Diabetes insipidus 0000873
Hyperplasia of midface
Midfacial excess
Midfacial prominence
[ more ]
0012371
Hypertelorism
Wide-set eyes
Widely spaced eyes
[ more ]
0000316
Large forehead
Increased size of forehead
0002003
Long face
Elongation of face
Increased height of face
Increased length of face
Vertical elongation of face
Vertical enlargement of face
Vertical overgrowth of face
[ more ]
0000276
Macrocephaly
Increased size of skull
Large head
Large head circumference
[ more ]
0000256
Muscular hypotonia
Low or weak muscle tone
0001252
Nephrocalcinosis
Too much calcium deposited in kidneys
0000121
Polyhydramnios
High levels of amniotic fluid
0001561
Premature birth
Premature delivery of affected infants
Preterm delivery
[ more ]
0001622
Thick lower lip vermilion
Increased volume of lower lip
Plump lower lip
Prominent lower lip
[ more ]
0000179
Thick upper lip vermilion
Full upper lip
Increased volume of upper lip
Plump upper lip
Prominent upper lip
Thick upper lip
[ more ]
0000215
Wide mouth
Broad mouth
Large mouth
[ more ]
0000154
Wide nasal bridge
Broad nasal bridge
Broad nasal root
Broadened nasal bridge
Increased breadth of bridge of nose
Increased breadth of nasal bridge
Increased width of bridge of nose
Increased width of nasal bridge
Nasal bridge broad
Wide bridge of nose
Widened nasal bridge
[ more ]
0000431
Percent of people who have these symptoms is not available through HPO
Absent speech
Absent speech development
Lack of language development
Lack of speech
No speech development
No speech or language development
Nonverbal
[ more ]
0001344
Astrocytosis 0002446
Autosomal recessive inheritance 0000007
Difficulty walking
Difficulty in walking
0002355
Facial hypotonia
Decreased facial muscle tone
Low facial muscle tone
Reduced facial muscle tone
[ more ]
0000297
Feeding difficulties
Feeding problems
Poor feeding
[ more ]
0011968
Generalized hypotonia
Decreased muscle tone
Low muscle tone
[ more ]
0001290
Global developmental delay 0001263
Inability to walk 0002540
Intellectual disability
Mental deficiency
Mental retardation
Mental retardation, nonspecific
Mental-retardation
[ more ]
0001249
Megalencephaly 0001355
Open mouth
Gaped jawed appearance
Gaped mouthed appearance
Slack jawed appearance
[ more ]
0000194
Seizure 0001250
Slender build
Thin build
0001533
Strabismus
Cross-eyed
Squint
Squint eyes
[ more ]
0000486
Ventriculomegaly 0002119
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Last updated: 7/1/2020

If you need medical advice, you can look for doctors or other healthcare professionals who have experience with this disease. You may find these specialists through advocacy organizations, clinical trials, or articles published in medical journals. You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.

If you can’t find a specialist in your local area, try contacting national or international specialists. They may be able to refer you to someone they know through conferences or research efforts. Some specialists may be willing to consult with you or your local doctors over the phone or by email if you can't travel to them for care.

You can find more tips in our guide, How to Find a Disease Specialist. We also encourage you to explore the rest of this page to find resources that can help you find specialists.

Healthcare Resources


These resources provide more information about this condition or associated symptoms. The in-depth resources contain medical and scientific language that may be hard to understand. You may want to review these resources with a medical professional.

In-Depth Information

  • Online Mendelian Inheritance in Man (OMIM) is a catalog of human genes and genetic disorders. Each entry has a summary of related medical articles. It is meant for health care professionals and researchers. OMIM is maintained by Johns Hopkins University School of Medicine. 
  • PubMed is a searchable database of medical literature and lists journal articles that discuss Polyhydramnios, megalencephaly, and symptomatic epilepsy syndrome. Click on the link to view a sample search on this topic.

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  1. Polyhydramnios, megalencephaly, and symptomatic epilepsy. OMIM. February, 2010; http://www.omim.org/entry/611087.
  2. Puffenberger EG. Polyhydramnios, megalencephaly and symptomatic epilepsy caused by a homozygous 7-kilobase deletion in LYK5. Brain. July, 2007; 130(Pt 7):1929-41. http://brain.oxfordjournals.org/content/130/7/1929.long.
  3. Ostendorf AP & Wong M.. mTOR inhibition in epilepsy: rationale and clinical perspectives. CNS Drugs. February, 2015; 29(2):91-9. http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4351152/.