Department of Systems Medicine, Unit of Child Neurology and Psychiatry, "Tor Vergata" University of Rome, 00133 Rome, Italy.
Unità Sanitaria Locale (USL) Umbria 2, Viale VIII Marzo, 05100 Terni, Italy.
Int J Mol Sci. 2018 Jul 6;19(7):1976. doi: 10.3390/ijms19071976.
Early infantile epileptic encephalopathies (EIEEs) are a group of neurological disorders characterized by early-onset refractory seizures, severe electroencephalographic abnormalities, and developmental delay or intellectual disability. Recently, genetic studies have indicated that a significant portion of previously cryptogenic EIEEs are single-gene disorders. is among the genes whose mutations are associated with EIEE development (OMIM# 613477). Here, a case of the c.6923_6928dup (p.Arg2308_Met2309dup) mutation associated with a severe EIEE is reported. This case shows that mutations in the α20 repeat in the C-terminal of αII spectrin can be associated with EIEE. Duplication seems essential to cause EIEE. This causation is not demonstrated for amino acid deletions in the same spectrin residues. Reportedly, children with p.(Asp2303_Leu2305del) and p.(Gln2304_Gly2306del) deletions have childhood-onset epilepsy and no or marginal magnetic resonance imaging abnormalities, suggesting that not only the location but also the type of mutation plays a role in conditioning nervous system damage. Further studies are needed for a better understanding of the phenotype/genotype correlation in -related encephalopathies.
早发性婴儿癫痫性脑病(EIEEs)是一组以早期起病、难治性癫痫发作、严重脑电图异常和发育迟缓或智力残疾为特征的神经发育障碍。最近的遗传学研究表明,以前病因不明的 EIEE 中有很大一部分是单基因疾病。 是与 EIEE 发展相关的基因突变之一(OMIM# 613477)。本文报道了一例与严重 EIEE 相关的 c.6923_6928dup(p.Arg2308_Met2309dup)突变。该病例表明,αII spectrin C 末端α20 重复区的突变可与 EIEE 相关。重复似乎是导致 EIEE 的必要条件。同样 spectrin 残基中的氨基酸缺失并不导致 EIEE。据报道,p.(Asp2303_Leu2305del) 和 p.(Gln2304_Gly2306del) 缺失的患儿有儿童期起病的癫痫,且磁共振成像无或轻微异常,这表明不仅突变位置,而且突变类型在调节神经系统损伤中起作用。需要进一步研究以更好地理解 - 相关脑病的表型/基因型相关性。