Cuijie Wei, Haipo Yang, Xiaona Fu, Aijie Liu, Juan Ding, Shujuan Song, Shuang Wang, Xingzhi Chang, Yanling Yang, Yuwu Jiang, Hui Xiong
Zhonghua Er Ke Za Zhi. 2015 Apr;53(4):274-9.
To summarize the clinical features of those Duchenne and Becker muscular dystrophy (DMD and BMD) patients who are complicated with epilepsy, and try to analyze the genotype- phenotype correlation.
By a retrospective analysis of 307 patients with DMD and BMD who attended Peking University First Hospital from February 2006 to September 2014,7 patients complicated with epilepsy were identified and their clinical data were collected. The possible mechanism of epilepsy in DMD and BMD patients was proposed after analyzing the genotype-phenotype correlation.
(1) Among 307 DMD and BMD patients, 7 cases had epilepsy, the prevalence was 2. 28%. (2) The age of onset of epilepsy ranged from 8 months to 11 years. Focal seizure was the most common seizure type (6 cases) , while other seizure types were also involved, such as generalized tonic-clonic seizure. As to epilepsy syndromes, 1 boy was diagnosed as benign childhood epilepsy with centrotemporal spikes (BECT). Six patients were treated with 1 or 2 types of antiepileptic drugs and seizures were controlled well. On follow-up, 6 of the 7 children had normal mental development, while the remaining 1 patient was diagnosed as mild mental retardation. (3) DMD gene mutations of all 7 patients were analyzed. Exons deletions were found in 6 cases while point mutation was found in 1 case.
The prevalence of epilepsy in DMD and BMD patients was higher than the prevalence in normal population. The age of onset of epilepsy varies, and focal seizure may be the most common seizure type. Some patients may also present as some kind of epilepsy syndrome, such as BECT. In most patients, seizures can be controlled well by 1 or 2 types of antiepiletic drugs. No clear correlation was found between genotype and phenotype in DMD and BMD patients who were complicated with epilepsy, probably due to limited number of cases.
总结杜氏和贝克型肌营养不良症(DMD和BMD)合并癫痫患者的临床特征,并尝试分析基因型与表型的相关性。
通过回顾性分析2006年2月至2014年9月在北京大学第一医院就诊的307例DMD和BMD患者,确定7例合并癫痫患者,并收集其临床资料。在分析基因型与表型相关性后,提出DMD和BMD患者癫痫发作的可能机制。
(1)307例DMD和BMD患者中,7例患有癫痫,患病率为2.28%。(2)癫痫发作年龄为8个月至11岁。局灶性发作是最常见的发作类型(6例),同时也涉及其他发作类型,如全身强直-阵挛发作。就癫痫综合征而言,1名男孩被诊断为伴中央颞区棘波的儿童良性癫痫(BECT)。6例患者使用1种或2种抗癫痫药物治疗,癫痫发作得到良好控制。随访时,7名儿童中有6名智力发育正常,其余1例被诊断为轻度智力低下。(3)对所有7例患者进行了DMD基因突变分析。6例发现外显子缺失,1例发现点突变。
DMD和BMD患者癫痫患病率高于正常人群。癫痫发作年龄各异,局灶性发作可能是最常见的发作类型。部分患者可能表现为某种癫痫综合征,如BECT。大多数患者使用1种或2种抗癫痫药物可使癫痫发作得到良好控制。DMD和BMD合并癫痫患者的基因型与表型之间未发现明确相关性,可能是由于病例数有限。