Pathophysiology

Tay-Sachs Disease is a genetic disorder caused by the absence of a vital enzyme called hexosaminidase A (Hex-A). This enzyme deficiency leads to the accumulation of GM2 ganglioside, a fatty substance, in the nerve cells of the brain and spinal cord, resulting in the progressive destruction of these cells. Tay-Sachs is inherited in an autosomal recessive pattern, meaning both copies of the gene in each cell have mutations.

Medical Diagnosis

Clinical Evaluation
Patient History: Family history of Tay-Sachs disease or related genetic conditions. Observation of developmental delays and neurological symptoms.
Physical Examination: Identification of characteristic signs such as the cherry-red spot on the retina.

Diagnostic Tests
Blood Test: Measurement of Hex-A enzyme activity. Reduced or absent activity indicates Tay-Sachs disease.
Genetic Testing: DNA analysis to detect mutations in the HEXA gene.
Prenatal Testing: Chorionic villus sampling (CVS) or amniocentesis can be performed to test for Tay-Sachs in the fetus if there is a known risk.

Signs and Symptoms

Loss of motor skills (e.g., crawling, sitting, turning over).
Exaggerated startle reaction to loud noises.
Seizures.
Vision and hearing loss.
Muscle weakness and loss of coordination.
Cherry-red spots in the eyes.
Paralysis.
Intellectual disability.
Progressive neurological decline.

Treatment

There is currently no cure for Tay-Sachs disease, and treatment focuses on managing symptoms and providing supportive care:
Supportive Care: Ensuring proper nutrition and hydration, managing infections, and providing physical therapy to maintain comfort and mobility as long as possible.
Medications: Anticonvulsants to manage seizures and other medications as needed to address specific symptoms.
Respiratory Care: Assistance with breathing, including suctioning and possibly ventilatory support as the disease progresses.
Palliative Care: Focusing on improving quality of life and providing relief from the symptoms and stress of the disease for both the patient and their family.
Genetic Counseling: For families to understand the risk of Tay-Sachs disease in future pregnancies and to explore reproductive options.