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Start free with EleplanFatal familial insomnia
ORPHA:466Disease
Also called FFI
What it is
A rare inherited human prion disease characterized by adult onset of progressive disturbance and loss of circadian rhythms, dysautonomia with increased sympathetic activity, and cognitive impairment with fluctuating vigilance, impaired long-term memory, disorientation, and oneiric states. Motor disturbances include myoclonus, cerebellar ataxia, and pyramidal signs. The disease rapidly leads to a somnolent or comatose state and is typically fatal after 9 or 30 months on average (bimodal course). Neuropathologic examination shows marked neuronal loss and gliosis predominantly in thalamic nuclei and inferior olives, while deposition of abnormal prion protein may be relatively sparse.
Key facts
- Prevalence
- <1 / 1 000 000
- Age of onset
- Adult
- 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
Very common80–99%
4- Abnormal autonomic nervous system physiology
- Dementia
- InsomniaDiagnostic criterion
- Myoclonus
Common30–79%
21- Abnormality of extrapyramidal motor functionDiagnostic criterion
- Anxiety
- Ataxia
- Bradyphrenia
- Cognitive impairment
- Depression
- Dysarthria
- Dysphagia
- Emotional labilityDiagnostic criterion
- Epiphora
- HallucinationsDiagnostic criterion
- HyperhidrosisDiagnostic criterion
- HypertensionDiagnostic criterion
- Laryngeal stridorDiagnostic criterion
- Reduced attention regulation
- Short rem sleepDiagnostic criterion
- Short term memory impairment
- Sleep apneaDiagnostic criterion
- Sleep-wake cycle disturbance
- TachycardiaDiagnostic criterion
- Thalamic hypometabolism in FDG PETDiagnostic criterion
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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