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阵发性运动诱发性运动障碍的临床表现与基因诊断

[Clinical manifestations and genetic diagnosis of paroxysmal kinesigenic dyskinesia].

作者信息

Zhu Xiao-Ming, Gong Yu-Hong, Lu Si, Cheng Shou-Chao, Yao Bao-Zhen

机构信息

Department of Pediatrics, Renmin Hospital of Wuhan University, Whuan 430060, China.

出版信息

Zhongguo Dang Dai Er Ke Za Zhi. 2017 Nov;19(11):1169-1173. doi: 10.7499/j.issn.1008-8830.2017.11.009.

Abstract

The clinical manifestations of five children with paroxysmal kinesigenic dyskinesia (PKD) were retrospectively analyzed and their gene mutations were analyzed by high-throughput sequencing and chromosome microarray. The 5 patients consisted of 4 males and 1 female and the age of onset was 6-9 years. Dyskinesia was induced by sudden turn movement, scare, mental stress, or other factors. These patients were conscious and had abnormal posture of unilateral or bilateral extremities, athetosis, facial muscle twitching, and abnormal body posture. The frequency of onset ranged from 3-5 times a month to 2-7 times a day, with a duration of <30 seconds every time. Electroencephalography showed no abnormality in these patients. Three patients had a family history of similar disease. The high-throughput sequencing results showed that a heterozygous mutation in the PRRT2 gene, c.649_650insC (p.R217PfsX8), was found in two patients; the mutation c.436C>T (p.P146S) was found in one patient; a splice site mutation, IVS2-1G>A, was found in one patient. The two mutations c.436C>T and IVS2-1G>A had not been reported previously. The chromosome microarray analysis was performed in one patient with negative results of gene detection, and the chromosome 16p11.2 deletion (0.55 Mb) was observed. Low-dose carbamazepine was effective for treatment of the 5 patients. PKD is a rare neurological disease. The detection of the PRRT2 gene by multiple genetic analysis can help the early diagnosis of PKD.

摘要

回顾性分析5例发作性运动诱发性运动障碍(PKD)患儿的临床表现,并采用高通量测序和染色体微阵列分析其基因突变情况。5例患者中男性4例,女性1例,发病年龄为6 - 9岁。运动障碍由突然转身、惊吓、精神压力或其他因素诱发。这些患者意识清醒,单侧或双侧肢体姿势异常、手足徐动、面部肌肉抽搐及身体姿势异常。发作频率从每月3 - 5次到每天2 - 7次不等,每次持续时间<30秒。脑电图检查显示这些患者无异常。3例患者有类似疾病家族史。高通量测序结果显示,2例患者PRRT2基因存在杂合突变c.649_650insC(p.R217PfsX8);1例患者发现突变c.436C>T(p.P146S);1例患者发现剪接位点突变IVS2 - 1G>A。c.436C>T和IVS2 - 1G>A这两个突变此前未见报道。对1例基因检测结果阴性的患者进行了染色体微阵列分析,观察到16号染色体p11.2缺失(0.55 Mb)。低剂量卡马西平治疗这5例患者有效。PKD是一种罕见的神经系统疾病。通过多种基因分析检测PRRT2基因有助于PKD的早期诊断。

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The clinical and genetic heterogeneity of paroxysmal dyskinesias.发作性运动障碍的临床和遗传异质性。
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Primary and secondary dystonic syndromes: an update.原发性和继发性肌张力障碍综合征:更新。
Curr Opin Neurol. 2013 Aug;26(4):406-12. doi: 10.1097/WCO.0b013e3283633696.
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PRRT2 mutations and paroxysmal disorders.PRRT2 突变与发作性疾病。
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