Cerebro-Oculo-Facio-Skeletal (COFS) Syndrome

What Is Cerebro-Oculo-Facio-Skeletal (COFS) Syndrome?

Skull and brain deformities and abnormalities are typically congenital and in many cases genetic, except in cases of trauma. Diseases, disorders and abnormal development of skulls, brains and the spine range in severity from easily treatable to fatal. Genetic testing and screenings during pregnancy can help with early detection in cases of congenital abnormalities. Cerebro-oculo-facio-skeletal (COFS) syndrome—also known as COFS syndrome and Pena-Shokeir syndrome, type II—is an inherited, degenerative disorder that involves the brain, eyes and spinal cord.

Types of Cerebro-Oculo-Facio-Skeletal (COFS) Syndrome

There are different variations of mutations, depending on which of the following genes is affected—ERCC1, ERCC2, ERCC5, or ERCC6—the latter condition is known as Cockayne syndrome type II.

Causes of Cerebro-Oculo-Facio-Skeletal (COFS) Syndrome

In most cases, the cause of cerebro-oculo-facio-skeletal (COFS) syndrome is unknown, but some cases have been identified by mutated genes which are thought to be the cause. COFS is characterized by skull, facial and skeletal abnormalities.

Risk Factors for Cerebro-Oculo-Facio-Skeletal (COFS) Syndrome

This rare condition is a neurodegenerative disease inherited and often connected with maternal age as well as a history of miscarriages.

Screening for & Preventing Cerebro-Oculo-Facio-Skeletal (COFS) Syndrome

Cerebro-oculo-facio-skeletal (COFS) syndrome develops as a genetic mutation and is typically diagnosed at birth. This condition can sometimes be detected by ultrasound technology, and more frequently with the advent of 3-D ultrasounds.

While this genetic disorder cannot be prevented, women who are of advanced maternal age or at higher risk of genetic abnormalities may opt to receive genetic counseling prior to becoming pregnant so that they understand the risks involved.

Signs & Symptoms of Cerebro-Oculo-Facio-Skeletal (COFS) Syndrome

A child with cerebro-oculo-facio-skeletal (COFS) syndrome may have an abnormally small jaw (micrognathia), clenched fists and wide-set nipples. Respiratory infections may be frequent. There is no cure for COFS syndrome, and most children do not live beyond five years. Treatment is supportive and symptomatic, as genetic counseling is available. Symptoms may include:

  • Impaired cognitive development, which can be severe
  • Abnormally small head (microcephaly)
  • Reduced muscle tone (hypotonia)
  • Impaired reflexes
  • Impaired vision
  • Involuntary eye movements

Diagnosing Cerebro-Oculo-Facio-Skeletal (COFS) Syndrome

Cerebro-oculo-facio-skeletal (COFS) syndrome develops as a genetic mutation and is typically diagnosed at birth. This condition can sometimes be detected by ultrasound technology, and more frequently with the advent of 3-D ultrasounds.

Infants with COFS typically need oxygen for respiratory issues. Additionally, these babies typically need tube feeding, and only have a lifespan of up to five years. These babies tend to suffer from extreme failure to thrive, with often insurmountable developmental delays.

Treating Cerebro-Oculo-Facio-Skeletal (COFS) Syndrome

Cerebro-oculo-facio-skeletal (COFS) syndrome can be detected in fetuses through ultrasound technology, genetic testing or it can be diagnosed at birth. Treatment is limited to symptomatic and support from a medical care team or COFS groups. Babies typically need tube feeding and oxygen due to respiratory distress.

Living with Cerebro-Oculo-Facio-Skeletal (COFS) Syndrome

Infants diagnosed with COFS suffer from severe respiratory infections and will typically die within the first five years of life.

To further your understanding of your diagnosis and to contribute to cutting-edge research, consider participating in a clinical trial so clinicians and scientists can learn more about causes, symptoms, treatment and prevention. Clinical research uses human volunteers to help researchers learn more about a disorder and perhaps find better ways to safely detect, treat or prevent disease.

All types of volunteers are needed—those who are healthy or may have an illness or disease—of all different ages, sexes, races and ethnicities to ensure that study results apply to as many people as possible, and that treatments will be safe and effective for everyone who will use them.

For information about participating in clinical research, visit NIH Clinical Research Trials and You. Learn about clinical trials currently looking for participants at Clinicaltrials.gov.