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ORPHA:166108Disease
Also called Birk-Barel Intellectual Disability-Dimorphism syndrome · Intellectual disability-hypotonia-facial dysmorphism syndrome · KCNK9 imprinting syndrome
What it is
Intellectual disability, Birk-Barel type is a rare, genetic, syndromic intellectual disability characterized by congenital central hypotonia, developmental delay, moderate to severe intellectual disability and subtle dysmorphic features which evolve over time (dolichocephaly, myopathic facies, ptosis, short and broad philtrum, tented upper lip vermillion, palatal anomalies, mild micro- and/or retrognathia). Patients present reduced facial movements, lethargy, weak cry, transient neonatal hypoglycemia, severe feeding difficulties and failure to thrive. Dysphagia, particularly of solid food, asthenic body build, joint contractures and scoliosis are additional features.
Key facts
- Prevalence
- <1 / 1 000 000
- Age of onset
- Infancy
- Inheritance
- Autosomal dominant
- Classified as
- Disease
Prevalence figures describe populations, not individuals, and are often estimates from a single study. Where the figure is an incidence or a birth prevalence, it says so.
Signs and symptoms
Common30–79%
26- Broad nasal tip
- Broad philtrum
- Dolichocephaly
- Dysphagia
- Dysphonia
- Fatigable weakness of skeletal muscles
- Fatiguable weakness of proximal limb muscles
- Feeding difficulties
- Generalized hypotonia
- Global developmental delay
- Highly arched eyebrow
- High, narrow palate
- Hyperactivity
- Hypomimic face
- Incisor macrodontia
- Micrognathia
- Narrow forehead
- Narrow nasal bridge
- Nasogastric tube feeding
- Neonatal hypotonia
- Open mouth
- Protruding ear
- Sacral dimple
- Short philtrum
- Tented upper lip vermilion
- Thick vermilion border
These ranges are how often a sign appears across everyone diagnosed, not a prediction for one person — most people have some of these and not others. Orphanet also records findings that are specifically absent in this disease; those are in the data but not listed here.
Gene
ICD-10 codes
ICD-10 has no distinct code for most rare diseases, so many are filed under the nearest available one. A shared code identifies the group, not this disease — the ORPHAcode above is what identifies it.
Related health topics
Reached through the ICD-10 categories this disease is filed under, so these describe the broader group rather than this disease specifically.
Cross-references
Orphadata Science: Free access data from Orphanet. © INSERM 1999. Data version 2026-06-23. Available under CC BY 4.0. This is a reference, not medical advice.
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