Angelman syndrome patients have global developmental delay, usually first noticed at 6-12 months of life. Most patients never develop speech, but some may have minimal use of words. All have frequent inappropriate laughter or smiling and significant motor delay—they begin walking at an average age of 4-5 years. Typical neurological manifestations are ataxia and tremulous movements. Most, but not all, have microcephaly. Most develop seizures before 3 years of age and have characteristic abnormal EEG patterns. Features that are present in most cases include characteristic appearance with flat occiput, protruding tongue, prognatia, wide smiling mouth, as well as hypopigmentation and strabismus (Fig. 1). Sleep disturbances and fascination with water can also be present. Clinical diagnostic criteria for AS have been developed by a panel of professionals experienced in the care for AS.
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The use of dumbbells gives you a much more comprehensive strengthening effect because the workout engages your stabilizer muscles, in addition to the muscle you may be pin-pointing. Without all of the belts and artificial stabilizers of a machine, you also engage your core muscles, which are your body's natural stabilizers.