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维生素B6治疗KCNQ2相关新生儿癫痫:两例报告及文献综述

KCNQ2-Related Neonatal Epilepsy Treated With Vitamin B6: A Report of Two Cases and Literature Review.

作者信息

Amore Greta, Butera Ambra, Spoto Giulia, Valentini Giulia, Saia Maria Concetta, Salpietro Vincenzo, Calì Francesco, Di Rosa Gabriella, Nicotera Antonio Gennaro

机构信息

Department of Human Pathology of the Adult and Developmental Age "Gaetano Barresi", Unit of Child Neurology and Psychiatry, University of Messina, Messina, Italy.

Department of Neuromuscular Disorders, Institute of Neurology, University College London, London, United Kingdom.

出版信息

Front Neurol. 2022 Mar 25;13:826225. doi: 10.3389/fneur.2022.826225. eCollection 2022.

Abstract

Potassium Voltage-Gated Channel Subfamily Q Member 2 (KCNQ2) gene has been initially associated with "Benign familial neonatal epilepsy" (BFNE). Amounting evidence arising by next-generation sequencing techniques have led to the definition of new phenotypes, such as neonatal epileptic encephalopathy (NEE), expanding the spectrum of KCNQ2-related epilepsies. Pyridoxine (PN) dependent epilepsies (PDE) are a heterogeneous group of autosomal recessive disorders associated with neonatal-onset seizures responsive to treatment with vitamin B6 (VitB6). Few cases of neonatal seizures due to KCNQ2 pathogenic variants have been reported as successfully responding to VitB6. We reported two cases of KCNQ2-related neonatal epilepsies involving a 5-year-old male with a paternally inherited heterozygous mutation (>; p.Arg547Trp), and a 10-year-old female with a heterozygous mutation (>; p.Ser247Leu). Both children benefited from VitB6 treatment. Although the mechanisms explaining the efficacy of VitB6 in such patients remain unclear, this treatment option in neonatal-onset seizures is easily taken into account in Neonatal Intensive Care Units (NICUs). Further studies should be conducted to better define clinical guidelines and treatment protocols.

摘要

钾离子电压门控通道Q亚家族成员2(KCNQ2)基因最初与“良性家族性新生儿癫痫”(BFNE)相关。下一代测序技术产生的大量证据导致了新表型的定义,如新生儿癫痫性脑病(NEE),扩大了KCNQ2相关癫痫的范围。维生素B6(PN)依赖性癫痫(PDE)是一组常染色体隐性疾病的异质性群体,与对维生素B6(VitB6)治疗有反应的新生儿发作有关。少数因KCNQ2致病变异导致的新生儿癫痫病例已被报道对VitB6治疗有成功反应。我们报告了两例KCNQ2相关的新生儿癫痫病例,其中一例是一名5岁男性,携带父系遗传的杂合突变(>;p.Arg547Trp),另一例是一名10岁女性,携带杂合突变(>;p.Ser247Leu)。两名儿童均从VitB6治疗中受益。尽管解释VitB6在此类患者中疗效的机制尚不清楚,但在新生儿重症监护病房(NICU)中,对于新生儿发作的这种治疗选择很容易被考虑到。应进行进一步研究以更好地确定临床指南和治疗方案。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/578e/8992372/5260095f09a0/fneur-13-826225-g0001.jpg

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