Molecular Neurosciences, Developmental Neurosciences Programme, UCL Great Ormond Street Institute of Child Health, London, UK.
Department of Neurology, Great Ormond Street Hospital, London, UK.
Dev Med Child Neurol. 2020 Feb;62(2):178-191. doi: 10.1111/dmcn.14407. Epub 2019 Nov 29.
An ever-increasing number of neurogenetic conditions presenting with both epilepsy and atypical movements are now recognized. These disorders within the 'genetic epilepsy-dyskinesia' spectrum are clinically and genetically heterogeneous. Increased clinical awareness is therefore necessary for a rational diagnostic approach. Furthermore, careful interpretation of genetic results is key to establishing the correct diagnosis and initiating disease-specific management strategies in a timely fashion. In this review we describe the spectrum of movement disorders associated with genetically determined epilepsies. We also propose diagnostic strategies and putative pathogenic mechanisms causing these complex syndromes associated with both seizures and atypical motor control. WHAT THIS PAPER ADDS: Implicated genes encode proteins with very diverse functions. Pathophysiological mechanisms by which epilepsy and movement disorder phenotypes manifest are often not clear. Early diagnosis of treatable disorders is essential and next generation sequencing may be required.
现在越来越多的神经遗传疾病表现为癫痫和非典型运动。这些“遗传性癫痫-运动障碍”谱系内的疾病在临床和遗传上具有异质性。因此,需要提高临床意识,以便进行合理的诊断方法。此外,仔细解释遗传结果是及时确定正确诊断和启动针对疾病的管理策略的关键。在这篇综述中,我们描述了与遗传性癫痫相关的运动障碍谱。我们还提出了诊断策略和可能的致病机制,这些机制导致与癫痫和非典型运动控制相关的复杂综合征。本文增加的内容:涉及的基因编码具有非常多样化功能的蛋白质。癫痫和运动障碍表型表现的病理生理机制通常不清楚。对可治疗疾病的早期诊断至关重要,可能需要进行下一代测序。