Happy Puppet Syndrome, also known as Angel Syndrome, or Angelman Syndrome, also known as Angerman Syndrome, is a disorder caused by a genetic defect. Patients suffering from this syndrome often have a smile on their face, lack of language skills, hyperactivity, and low intelligence. I. Etiology: Happy puppet syndrome, also known as Engelmann syndrome, is caused by a genetic defect that is the result of a deletion of chromosome 15, q11-q13. The disease is caused by a maternal monogenic genetic defect. Clinical manifestations: 1. It is characterized by severe motor impairment, mental retardation, ataxia, hypotonia, epilepsy, speech disorders and a special face characterized by a huge jaw and an open mouth with an exposed tongue as well as crying when teased. 2. All patients exhibit laughter, occipital sulcus, abnormal tongue extension (extended tongue), and characteristic EEG discharges (EEG pattern consisting of high amplitude bilateral peaks and wave activity, symmetrically synchronized and often with a single rhythm, and with a slow wave component of two cycles per second). 3. Some patients have motor tremors and walking difficulties, which may be due to balance dysfunction. 4. Grand mal seizures, with frequent up-and-down fluttering-like movements of the upper limbs with frequent elbow flexion during the same period. 5. Generalized developmental delay, postnatal microcephaly, convulsions, hypotonia, hyperreflexia, and hyperactivity. 6.CT confirmed that the patient had unilateral cerebral atrophy. 7. Some patients had aphasia or all had language deficits; 39% of patients had lower pigmentation than normal in their family line, with hypopigmentation characterized by light skin color, reduced retinal pigmentation, low hair follicle tyrosinase activity, and incomplete melanization of melanosomes as part of the AS phenotype, similar to that seen in Prader-Willi syndrome. 8. Ocular features all patients have abnormal choroidal pigmentation and some patients have optic nerve atrophy; some patients have ocular skin albinism and choroidal pigment dysplasia. This condition is incurable and can only be alleviated by aging.