Affordable Access

deepdyve-link
Publisher Website

De-novo mutations in patients with chronic ultra-refractory epilepsy with onset after age five years.

Authors
  • McCormack, Mark1
  • McGinty, Ronan N2
  • Zhu, Xiaolin3
  • Slattery, Lisa4
  • Heinzen, Erin L3
  • Costello, Daniel J5
  • Delanty, Norman6
  • Cavalleri, Gianpiero L7
  • 1 Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Ireland; Department of Genetics, Universitair Medisch Centrum Utrecht, Utrecht, Netherlands. , (Ireland)
  • 2 Department of Neurology, Cork University Hospital, Wilton, Cork, Ireland; Nuffield Department of Clinical Neurosciences, John Radcliffe Hospital, Oxford, United Kingdom. , (United Kingdom)
  • 3 Institute for Genomic Medicine, Columbia University Medical Center, New York, NY, USA.
  • 4 Department of Neurology, St. James' Hospital, Dublin 8, Ireland. , (Ireland)
  • 5 Department of Neurology, Cork University Hospital, Wilton, Cork, Ireland. , (Ireland)
  • 6 Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Ireland; Department of Neurology, Beaumont Hospital, Dublin 9, Ireland; The FutureNeuro Research Centre, RCSI, Dublin, Ireland. , (Ireland)
  • 7 Department of Molecular and Cellular Therapeutics, Royal College of Surgeons in Ireland, Ireland; The FutureNeuro Research Centre, RCSI, Dublin, Ireland. Electronic address: [email protected] , (Ireland)
Type
Published Article
Journal
European journal of medical genetics
Publication Date
Jan 01, 2020
Volume
63
Issue
1
Pages
103625–103625
Identifiers
DOI: 10.1016/j.ejmg.2019.01.015
PMID: 30711678
Source
Medline
Keywords
Language
English
License
Unknown

Abstract

We set out to investigate whether a de-novo paradigm could explain genetic causes of chronic ultra-refractory epilepsy, with onset later than the typical age for the epileptic encephalopathies. We performed exome sequencing on nine adult patients with MRI-negative epilepsy and no preceding intellectual disability. All had an onset of seizures after five years old and had chronic ultra-refractory epilepsy defined here as having failed more than six anti-epileptic drugs and currently experiencing ≥4 disabling seizures per month. Parents were sequenced to identify de-novo mutations and these were assessed for likelihood of pathogenicity based on the American College of Medical Genetics and Genomics (ACMG) criteria. We confirmed the presence of functional and predicted-damaging de-novo mutations in 3/9 patients. One of these pathogenic de-novo mutations, in DNM1L, was previously reported in a patient with severe epilepsy and chronic pharmacoresistance adding to the evidence for DNM1L as an epilepsy gene. Exome sequencing is a successful strategy for identifying de-novo mutations in paediatric epileptic encephalopathies and rare neurological disorders. Our study demonstrates the potential benefit of considering ultra-refractory epilepsy patients with later onset for genetic testing. Identifying genetic mutations underpinning severe epilepsy of unknown aetiology may provide new insight into the underlying biology and offers the potential for therapeutic intervention in the form of precision medicine in older patients. Copyright © 2019 The Authors. Published by Elsevier Masson SAS.. All rights reserved.

Report this publication

Statistics

Seen <100 times