Surveillance: Monitor development, growth, skin, sleep issues, and family needs at each visit. In adulthood, a residential facility for individuals with PWS that helps regulate behavior and weight management may prevent morbid obesity, and growth hormone may help to maintain muscle mass. Developmental services and educational support hormonal and surgical treatments can be considered for cryptorchidism growth hormone therapy to normalize height, increase lean body mass and mobility, and decrease fat mass endocrine management of sex hormone replacement at puberty treatment for those with precocious puberty, type 2 diabetes, and hypothyroidism urgent evaluation for those with acute gastrointestinal manifestations topiramate or N-acetylcysteine as needed for skin picking standard treatment for neurobehavioral and ophthalmologic manifestations, sleep issues, scoliosis, hip dysplasia, and seizures modafinil may be helpful for daytime sleepiness calcium and vitamin D supplementation to avoid osteoporosis sex steroid therapy, growth hormone, or bisphosphonates for low bone density products for dry mouth and frequent dental hygiene social work support and care coordination. In childhood, strict supervision of daily food intake based on height, weight, and body mass index (BMI) to provide energy requirements while limiting excessive weight gain (maintain BMI z score <2) encourage physical activity. Treatment of manifestations: In infancy, special nipples or nasogastric tube feeding to assure adequate nutrition.
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