Journal of Pediatric Neurology 2021; 19(04): 264-269
DOI: 10.1055/s-0040-1716546
Case Report

Gratification Disorder as an Early Marker of Rett Syndrome: Two Pediatric Case Reports

Kanya Singhapakdi
1   Department of Pediatrics, University of South Alabama, Mobile, Alabama, United States
Paul Maertens
2   Division of Child Neurology, Department of Neurology, University of South Alabama, Mobile, Alabama, United States
› Author Affiliations
Funding None.


Gratification disorder (GD) is a form of stereotyped posturing with mechanical pressure applied to the genitalia without manual manipulation and is generally considered benign. Here, we describe two patients who exhibited GD. Both were later diagnosed with Rett syndrome via genetic sequencing. In both patients, GD preceded the onset of the hallmark hand stereotypies of Rett syndrome. We therefore conclude that GD is not as benign as previously assumed and in fact can be an early sign of Rett syndrome. Further studies are needed to evaluate the prevalence of GD in Rett girls with the MECP2 genotype.

Publication History

Received: 29 May 2020

Accepted: 09 August 2020

Article published online:
23 September 2020

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