CADASIL is an autosomal
dominant condition. This means that if a parent has it, each of
the parent's children has a fifty percent chance of having it as well.
For many families, this is an especially difficult aspect of CADASIL
to deal with. Parents may worry about their children's health and wonder
if they should be tested for CADASIL. Patients
who experienced the illness of their own parent or grandparent with
CADASIL may find it upsetting to think about how the condition will
affect them as they grow older. These are normal concerns. You may want
to discuss them with your physician, a genetics counselor, or a therapist.
Our view is that
it is appropriate and important, at some point in time, for your children
to learn of your disease and the fact that it is hereditary. This information
may be particularly important with respect to your adult children’s
family planning. There is no “best time” to talk with your
children about CADASIL, and the decision will depend on many factors
such as their age, maturity, and typical psychological reactions to
stressful news. Parents often have a better sense of this than do physicians.
As a rule of thumb, we feel that the discussion should preferably occur
before the start of family planning.