Department of Pediatric Neurology, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University, Wenzhou, China.
Department of Pediatric, The First People's Hospital of Aksu District, Xinjiang Uygur Autonomous Region, China.
Acta Neurol Belg. 2020 Aug;120(4):1025-1028. doi: 10.1007/s13760-020-01348-9. Epub 2020 Apr 3.
To analyze the clinical characteristics and PRRT2 gene mutation of self-limited familial infantile epilepsy and evaluate the treatment responses of different antiepileptic drugs in self-limited familial infantile epilepsy. We reviewed the clinical feature and genetic mutation results and treatment responses of two sibling sisters. They were detected with the PRRT2 gene mutation through Sanger sequencing. Elder sister was treated with oxcarbazepine oral suspension, while younger sister was treated with levetiracetam oral solution. The two sibling sisters exhibited PRRT2 heterozygous mutation inherited from their mother in c.649dupC p.(Arg217fs). Oxcarbazepine oral suspension had an immediate effect on the elder sister who was treated with it. However, levetiracetam oral solution had no effect on younger sister even though the dose was increased, but she got seizure-free after turning to oxcarbazepine oral suspension. Oxcarbazepine, which plays the mechanism of the sodium channel blockers, has a more significant effect than levetiracetam, which has no mechanism of the sodium channel blockers in self-limited familial infantile epilepsy. The PRRT2 gene of infantile epileptic patients with a family history of infantile convulsions or paroxysmal kinesigenic dyskinesia(PKD) could be detected by sanger sequencing and a biomarker to select antiepileptic drugs which play the mechanism of the sodium channel blockers could be utilized.
分析限局性家族性婴儿癫痫的临床特征和 PRRT2 基因突变,并评估不同抗癫痫药物在限局性家族性婴儿癫痫中的治疗反应。我们回顾了两位姐妹的临床特征、基因突变结果和治疗反应。通过 Sanger 测序发现她们均携带 PRRT2 基因突变,姐姐予奥卡西平混悬液治疗,妹妹予左乙拉西坦口服液治疗。两姐妹均遗传自母亲的 PRRT2 基因 c.649dupC p.(Arg217fs)杂合突变。奥卡西平混悬液对姐姐起效迅速,而左乙拉西坦口服液对妹妹无效,即使增加剂量也无济于事,改为奥卡西平混悬液后妹妹癫痫无发作。奥卡西平作为钠离子通道阻滞剂发挥作用,其效果优于无钠离子通道阻滞剂作用机制的左乙拉西坦,在限局性家族性婴儿癫痫中。有婴儿癫痫家族史或阵发性运动诱发性运动障碍(PKD)的婴儿癫痫患者可通过 Sanger 测序检测 PRRT2 基因,并可利用钠离子通道阻滞剂作用机制的生物标志物来选择抗癫痫药物。