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CDKL5 缺乏症,不伴癫痫。

CDKL5 Deficiency Disorder Without Epilepsy.

机构信息

Paediatric Neurology, Hospital del Mar, Barcelona, Spain; Program in Neurosciences, Hospital del Mar Research Institute (IMIM), Barcelona, Spain; Department of Medicine and Life Sciences, Universitat Pompeu Fabra, Barcelona, Spain.

Paediatric Neurology, Quironsalud Hospital, Madrid, Spain.

出版信息

Pediatr Neurol. 2023 Jul;144:84-89. doi: 10.1016/j.pediatrneurol.2023.04.015. Epub 2023 Apr 26.

Abstract

Cyclin-dependent kinase-like 5 (CDKL5) deficiency disorder (CDD) has epilepsy as a cardinal feature. Here we report two new female patients and review six previously published patients, one male and five females, with features of CDD but who never developed epilepsy. In contrast with the classical and severe CDD phenotype, they presented with milder gross motor delays, autism spectrum disorder, and no visual cortical impairment. Prolonged video electroencephalography was normal in adult cases but showed interictal frontal-temporal bilateral spikes and sharp waves in sleep in the three-year-old girl. Causative CDKL5 variants included two likely gene damaging (nonsense and frameshift) and six missense variants, being de novo or maternally inherited from asymptomatic females with skewed X-chromosome inactivation (two missense variants). Our data indicate that a milder form of CDD without epilepsy can occur in some cases without clear correlation with specific variants in the CDKL5 gene.

摘要

周期素依赖性激酶样 5(CDKL5)缺乏症(CDD)的主要特征是癫痫。在这里,我们报告了两名新的女性患者,并回顾了之前发表的六名患者,其中一名男性和五名女性,具有 CDD 的特征,但从未发生过癫痫。与经典和严重的 CDD 表型相反,他们表现为较轻的粗大运动发育迟缓、自闭症谱系障碍,且没有视觉皮质损伤。在成年患者中,长时间视频脑电图正常,但在三岁女孩的睡眠中显示出间发性额颞部双侧棘波和尖波。致病的 CDKL5 变体包括两个可能的基因破坏性(无义和移码)和六个错义变体,是从头发生的或从无症状的女性那里继承来的,她们的 X 染色体失活存在偏倚(两个错义变体)。我们的数据表明,在某些情况下,没有癫痫的 CDD 较轻形式可能发生,与 CDKL5 基因的特定变体没有明确的相关性。

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