Zhou Xihui, Ma Aiqun, Liu Xiaohong, Huang Chen, Zhang Yanmin, Shi Ruiming, Mao Shiwei, Geng Tao, Li Shengbin
Department of Pediatrics, First Affiliated Hospital, Ion Channel Disease Laboratory, Medical College of Xi'an Jiaotong University, Xi'an, Shaanxi, People's Republic of China.
Eur J Pediatr. 2006 Oct;165(10):691-5. doi: 10.1007/s00431-006-0157-5. Epub 2006 May 12.
Benign familial infantile seizures (BFIS) is a form of idiopathic epilepsy characterized by clusters of afebrile seizures occurring around the sixth month of life and a favorable outcome. Linkage analysis has revealed that three chromosomal segments, 19q12-q13.1, 16p12-q12, and 2q23-31, are linked to this disorder.
We report here a large Chinese family in which all 17 affected members had had infantile seizures with onset at age 2-4 months, with two of these also manifesting seizures later in life accompanied with either choreoathetosis or myokymia. Linkage analysis in this family confirmed a previous report of genetic heterogeneity in BFIS - since linkage was excluded at the above-mentioned known BFIS loci - and suggested a possible linkage to the KCNQ2 gene, which is believed to be a voltage gated potassium channel gene responsible for benign familial neonatal seizures (BFNS).
Sequencing of the KCNQ2 gene revealed that all 17 affected family members carried a heterozygous Gly-to-Val (G271V) mutation in the conserved pore region that resulted from a guanine-to-thymine transition in exon 5 of KCNQ2. The same mutation with a comparable localization in the KCNQ3 (G310V) gene has been found in BFNS patients. The same conserved amino acid was also found to be mutated in the KCNQ1 gene in a family with Long QT Syndrome.
良性家族性婴儿惊厥(BFIS)是特发性癫痫的一种形式,其特征为在出生后约6个月时出现无热惊厥发作群,且预后良好。连锁分析显示,三个染色体片段,即19q12 - q13.1、16p12 - q12和2q23 - 31,与该疾病相关。
我们在此报告一个大型中国家族,其中所有17名受累成员在2 - 4个月大时均出现婴儿惊厥,其中两人在生命后期还出现了伴有舞蹈手足徐动症或肌束震颤的惊厥发作。该家族的连锁分析证实了先前关于BFIS遗传异质性的报道——因为在上述已知的BFIS基因座处排除了连锁关系——并提示可能与KCNQ2基因连锁,该基因被认为是一种电压门控钾通道基因,与良性家族性新生儿惊厥(BFNS)有关。
KCNQ2基因测序显示,所有17名受累家族成员在保守的孔区携带杂合的甘氨酸到缬氨酸(G271V)突变,该突变是由KCNQ2基因第5外显子中的鸟嘌呤到胸腺嘧啶的转换导致的。在BFNS患者中也发现了KCNQ3基因(G310V)中具有类似定位的相同突变。在一个患有长QT综合征的家族中,KCNQ1基因中也发现了相同的保守氨基酸发生突变。