A syndrome characterized by multiple abnormalities, mental retardation, and movement disorders. Present usually are skull and other abnormalities, frequent infantile spasms (spasms, infantile); easily provoked and prolonged paroxysms of laughter (hence "happy"); jerky puppetlike movements (hence "puppet"); continuous tongue protrusion; motor retardation; ataxia; muscle hypotonia; and a peculiar facies. It is associated with maternal deletions of chromosome 15q11-13 and other genetic abnormalities. (From Am j med Genet 1998 Dec 4;80(4):385-90; Hum Mol Genet 1999 Jan;8(1):129-35)