Zusammenfassung
Als Ursachen epileptischer Enzephalopathien (EE) sind Läsionen, Fehlbildungen, Stoffwechselerkrankungen und genetische Veränderungen zu nennen. Gerade in den letzten Jahren wurden Fortschritte im Verständnis der Genetik epileptischer Enzephalopathien gemacht. Da diese Erkrankungen einerseits mit wenigen Ausnahmen genetisch sehr heterogen erscheinen und andererseits eine Vielzahl genetischer Untersuchungen verfügbar ist, gestaltet sich die Auswahl der gendiagnostischen Verfahren schwierig. Der vorliegende Beitrag gibt einen Überblick über die genetische Herangehensweise an EE anhand von 3 Leitphänotypen (neonatale EE, infantile EE und EE des Kleinkind-/frühen Kindesalters).
Abstract
The causes of epileptic encephalopathies are lesions, malformations, metabolic diseases and genetic alterations. Advances have very recently been made in the understanding of the genetics of epileptic encephalopathies. Because on the one hand these diseases with few exceptions appear to be genetically very heterogeneous and on the other hand many genetic investigations are available, the selection for genetic diagnostics is difficult. This article gives an overview of the genetic approach to epileptic encephalopathies exemplified by the three main phenotypes (neonatal, infantile and early childhood epileptic encephalopathies).
Literatur
Guerrini R (2006) Epilepsy in children. Lancet 367:499–524
Moller RS et al (2013) Exon-disrupting deletions of NRXN1 in idiopathic generalized epilepsy. Epilepsia 54:256–264
Novarino G, Baek ST, Gleeson JG (2013) The sacred disease: the puzzling genetics of epileptic disorders. Neuron 80:9–11
Dixon-Salazar TJ et al (2012) Exome sequencing can improve diagnosis and alter patient management. Sci Transl Med 4:138ra78
Claes L et al (2001) De novo mutations in the sodium-channel gene SCN1A cause severe myoclonic epilepsy of infancy. Am J Hum Genet 68:1327–1332
Barcia G et al (2012) De novo gain-of-function KCNT1 channel mutations cause malignant migrating partial seizures of infancy. Nat Genet 44:1255–1259
Carvill GL et al (2013) GRIN2A mutations cause epilepsy-aphasia spectrum disorders. Nat Genet 45:1073–1076
Lemke JR et al (2013) Mutations in GRIN2A cause idiopathic focal epilepsy with rolandic spikes. Nat Genet 45:1067–1072
Lesca G et al (2013) GRIN2A mutations in acquired epileptic aphasia and related childhood focal epilepsies and encephalopathies with speech and language dysfunction. Nat Genet 45:1061–1066
Helbig I et al (2008) Navigating the channels and beyond: unravelling the genetics of the epilepsies. Lancet Neurol 7:231–245
Specchio N et al (2012) Epilepsy in ring 14 chromosome syndrome. Epilepsy Behav 25:585–592
Radhakrishnan A et al (2012) The evolving electroclinical syndrome of „epilepsy with ring chromosome 20“. Seizure 21:92–97
Battaglia A, Carey JC (2005) Seizure and EEG patterns in Wolf-Hirschhorn (4p-) syndrome. Brain Dev 27:362–364
Helbig I et al (2013) Structural genomic variation in childhood epilepsies with complex phenotypes. Eur J Hum Genet. DOI 10.1038/ejhg.2013.262
Mefford HC et al (2011) Rare copy number variants are an important cause of epileptic encephalopathies. Ann Neurol 70:974–985
Mefford HC, Eichler EE (2009) Duplication hotspots, rare genomic disorders, and common disease. Curr Opin Genet Dev 19:196–204
Carvill GL et al (2013) Targeted resequencing in epileptic encephalopathies identifies de novo mutations in CHD2 and SYNGAP1. Nat Genet 45:825–830
Lemke JR et al (2012) Targeted next generation sequencing as a diagnostic tool in epileptic disorders. Epilepsia 53:1387–1398
Krumm N et al (2013) Transmission disequilibrium of small CNVs in simplex autism. Am J Hum Genet 93:595–606
Beal JC, Cherian K, Moshe SL (2012) Early-onset epileptic encephalopathies: Ohtahara syndrome and early myoclonic encephalopathy. Pediatr Neurol 47:317–323
Nakamura K et al (2013) Clinical spectrum of SCN2A mutations expanding to Ohtahara syndrome. Neurology 81:992–998
Depienne C et al (2012) Genes in infantile epileptic encephalopathies. In: Noebels JL et al (Hrsg) Jasper’s basic mechanisms of the epilepsies. Bethesda
Epi KC et al (2013) De novo mutations in epileptic encephalopathies. Nature 501:217–221
Biervert C et al (1998) A potassium channel mutation in neonatal human epilepsy. Science 279:403–406
Heron SE et al (2002) Sodium-channel defects in benign familial neonatal-infantile seizures. Lancet 360:851–852
Weckhuysen S et al (2012) KCNQ2 encephalopathy: emerging phenotype of a neonatal epileptic encephalopathy. Ann Neurol 71:15–25
Dravet C et al (2005) Severe myoclonic epilepsy in infancy (Dravet syndrome). In: Roger J et al (Hrsg) Epileptic syndromes in infancy, childhood and adolescence. Libbey Eurotext, Montrouge, S 77–88
Harkin LA et al (2007) The spectrum of SCN1A-related infantile epileptic encephalopathies. Brain 130:843–852
Ebach K et al (2005) SCN1A mutation analysis in myoclonic astatic epilepsy and severe idiopathic generalized epilepsy of infancy with generalized tonic-clonic seizures. Neuropediatrics 36:210–213
Depienne C et al (2009) Sporadic infantile epileptic encephalopathy caused by mutations in PCDH19 resembles Dravet syndrome but mainly affects females. PLoS Genet 5:e1000381
Suls A et al (2013) De novo loss-of-function mutations in CHD2 cause a fever-sensitive myoclonic epileptic encephalopathy sharing features with Dravet syndrome. Am J Hum Genet 93:967–975
Nakamura K et al (2013) De Novo mutations in GNAO1, encoding a Galphao subunit of heterotrimeric G proteins, cause epileptic encephalopathy. Am J Hum Genet 93:496–505
Helbig I (2013) Infantile spasms/Lennox-Gastaut genetics goes transatlantic, in Beyond the Ion Channel – the Channelopathist. http/www.channelopathist.net/
Yu TW et al (2013) Using whole-exome sequencing to identify inherited causes of autism. Neuron 77:259–273
Baumgart A et al (2013) Atypical vitamin B6 deficiency: a rare cause of unexplained neonatal and infantile epilepsies. J Child Neurol. DOI 10.1177/0883073813505354
Baalen A van et al (2010) Febrile infection-related epilepsy syndrome (FIRES): a nonencephalitic encephalopathy in childhood. Epilepsia 51:1323–1328
Kovel CG de et al (2007) Association analysis of BRD2 (RING3) and epilepsy in a Dutch population. Epilepsia 48:2191–2192
Helbig I et al (2009) 15q13.3 microdeletions increase risk of idiopathic generalized epilepsy. Nat Genet 41:160–162
Mefford HC et al (2010) Genome-wide copy number variation in epilepsy: novel susceptibility loci in idiopathic generalized and focal epilepsies. PLoS Genet 6:e1000962
Suls A et al (2009) Early-onset absence epilepsy caused by mutations in the glucose transporter GLUT1. Ann Neurol 66:415–419
Mullen SA et al (2011) Glucose transporter 1 deficiency as a treatable cause of myoclonic astatic epilepsy. Arch Neurol 68:1152–1155
Muhle H et al (2013) The role of SLC2A1 in early onset and childhood absence epilepsies. Epilepsy Res 105:229–233
Reutlinger C et al (2010) Deletions in 16p13 including GRIN2A in patients with intellectual disability, various dysmorphic features, and seizure disorders of the rolandic region. Epilepsia 51:1870–1873
Baraban SC, Dinday MT, Hortopan GA (2013) Drug screening in Scn1a zebrafish mutant identifies clemizole as a potential Dravet syndrome treatment. Nat Commun 4:2410
Cherepanova NS et al (2013) Presence of epilepsy-associated variants in large exome databases. J Neurogenet 27:1–4
Vassos E et al (2010) Penetrance for copy number variants associated with schizophrenia. Hum Mol Genet 19:3477–3481
Helbig I, Hodge SE, Ottman R (2013) Familial cosegregation of rare genetic variants with disease in complex disorders. Eur J Hum Genet 21:444–450
Miller DT et al (2010) Consensus statement: chromosomal microarray is a first-tier clinical diagnostic test for individuals with developmental disabilities or congenital anomalies. Am J Hum Genet 86:749–764
Einhaltung ethischer Richtlinien
Interessenkonflikt. I. Helbig, H. Harms, H. Muhle geben an, dass kein Interessenkonflikt besteht. Der Beitrag enthält keine Studien an Menschen oder Tieren.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Helbig, I., Harms, H. & Muhle, H. Genetik epileptischer Enzephalopathien. Z. Epileptol. 27, 93–99 (2014). https://doi.org/10.1007/s10309-013-0352-0
Published:
Issue Date:
DOI: https://doi.org/10.1007/s10309-013-0352-0
Schlüsselwörter
- Mutation
- Sequenzanalyse, DNA
- Genetische Variationen
- DNA-Kopienzahl-Variationen
- Individualisierte Medizin