Description： The progressive myoclonus epilepsies （PME＇s） comprise a large group of genetically determined disorders characterized by myoclonus, generalized tonic-clonic seizures, cerebellar dysfunction and variab...Description： The progressive myoclonus epilepsies （PME＇s） comprise a large group of genetically determined disorders characterized by myoclonus, generalized tonic-clonic seizures, cerebellar dysfunction and variable degrees of cognitive impairment.展开更多
Background:Progressive myoclonic epilepsy(PME)is a group of neurodegenerative diseases with genetic heterogeneity and phenotypic similarities,and many cases remain unknown of the genetic causes.This study is aim to su...Background:Progressive myoclonic epilepsy(PME)is a group of neurodegenerative diseases with genetic heterogeneity and phenotypic similarities,and many cases remain unknown of the genetic causes.This study is aim to summarize the clinical features and study the genetic causes of PME patients.Methods:Sanger sequencing of the target gene,Next Generation Sequencing(NGS)panels of epilepsy,trio-based Whole Exome Sequencing(WES)and detection of cytosine-adenine-guanine(CAG)repeat number were used to investigate the genetic causes of PME patients.Results:Thirty-eight children with PME whose seizure onset age ranged from 3 months to 12 years were collected from February 2012 to November 2019 in three hospitals in Beijing,China.The seizure types included myoclonic seizures(n=38),focal seizures(n=19),generalized tonic-clonie seizure(GTCS)(n=13),absence seizures(n=4),atonic seizures(n=3),epileptic spasms(n=2)and tonic seizures(n=1).Twenty-seven cases were sporadic and 11 had family members affected.Established PME-related genes were identified in 30 out of 38(78.9%)patients who had either recessively inherited or de novo heterozygous mutations.Among these 30 cases,there were 12 cases(31.6%)of neuronal ceroid lipofuscinoses(the causing gene contains TPP1,PPT1,CLN5,CLN6 and MFSD8),two cases of sialidosis(the causing gene is NEU1),two cases of neuronopathic Gaucher disease(the causing gene is GBA),one case of spinal muscular atrophy-progressive myoclonic epilepsy(the causing gene is ASAH1),four cases of KCNC1 mutation-related PME,four cases of KCTD7 mutation-related PME,two cases of TBC1D24 mutation-related PME,one case of GOSR2 related PME,and two of dentatorubral-pallidoluysian atrophy(the causing gene is ATN1).In total,13 PME genes were identified in our cohort.The etiology was not clear in eight patients.Conclusion:PME is a group of clinically and genetically heterogeneous diseases.Genetic diagnosis was clear in 78.9%of PME patients.Various of genetic testing methods could increase the rate of genetic diagnosis.Neuronal ceroid lipofuscinoses(NCL)is the most common etiology of PME in children.Nearly one third PME children were diagnosed with NCL.GOSR2 related PME was in our cohort in Asia for the first time.展开更多
Background： Progressive myoclonus epilepsies （PMEs） conaprise a group of rare genetic disorders characterized by action rnyoclonus, epileptic seizures, and ataxia with progressive neurologic decline. Due to clinica...Background： Progressive myoclonus epilepsies （PMEs） conaprise a group of rare genetic disorders characterized by action rnyoclonus, epileptic seizures, and ataxia with progressive neurologic decline. Due to clinical and genetic heterogeneity of PMEs, it is difficult to decide which genes are affected. The aim of this study was to report an action myoclonus with or without renal failure syndrome （EPM4） fhmily and summarize the clinical and genetic characteristics of all reported EPM4 patients. Meihods： In the present study, targeted next-generation sequencing （NGS） was applied to screen causative genes in a Chinese PME family. The candidaie variant was further confirmed by cosegregation analysis and further functional analysis, including the reverse transcription polymerase chain reaction and Western blot of the proband＇s muscle. Moreovel, literature data on the clinical and mutational features of all reported EPM4 patients were reviewed. Results： The gene analysis revealed a novel homozygous splicing mutation （c.995-1G〉A） of the SCARB2 gene in two brothers. Further functional analysis revealed that this mutation led to loss function of the SCARB2 protein. The classification of the candidate variant, according to the American College of Medical Genetics and Genomics standards and guidelines and functional analysis, was pathogenic. Therefore, these two brothers were finally diagnostically confirmed as EPM4. Conclusions： These present results suggest the potential for targeted NGS to conduct a more rapid and precise diagnosis for PME patients. A literature review revealed that mutations in the different functional domains of SCARB2 appear to be associated with the phenotype of EPM4.展开更多
目的为临床合理使用拉莫三嗪(LTG)提供参考。方法检索中国知网、万方、维普、PubMed、Web of Science数据库自建库起至2023年11月的LTG治疗药物监测相关文献,从治疗窗、药物代谢动力学(简称药动学)特征,特殊人群(妊娠期女性、儿童、老...目的为临床合理使用拉莫三嗪(LTG)提供参考。方法检索中国知网、万方、维普、PubMed、Web of Science数据库自建库起至2023年11月的LTG治疗药物监测相关文献,从治疗窗、药物代谢动力学(简称药动学)特征,特殊人群(妊娠期女性、儿童、老年人等)药动学特征及代谢酶相关基因多态性对血药浓度的影响等方面,总结LTG治疗药物监测研究进展。结果LTG是治疗癫痫发作和双相情感障碍的药物,临床应用时需参考最新治疗窗;临床监测样本以血浆为主,头发和唾液也可作为非入侵样本;血药浓度检测的主要方法为液相色谱法,荧光光谱法和电化学传感器正逐渐被应用。LTG生物利用度约为98%,蛋白质结合率约为55%,达峰时间不受给药剂量限制;在与其他药物联用时要注意调整剂量。有潜在生育能力的癫痫女性用药首选LTG,用于老年癫痫时更适用于新发患者,对于癫痫患儿应重点监测血药浓度,以避免发生不良反应。尿苷5'-二磷酸-葡萄糖醛酸糖基转移酶是参与LTG代谢的主要酶,其相关基因的多态性也是血药浓度的重要影响因素。结论应采用合适的样本和方法检测LTG血药浓度,并关注不同人群及不同基因型,以预防严重不良反应的发生。展开更多
Juvenile myoclonic epilepsy (JME) is characterised by myoclonia during awakening, generalised tonic-clonic seizures, typical absences and usually presents for the first time at the age of 12 to 18 years old. This arti...Juvenile myoclonic epilepsy (JME) is characterised by myoclonia during awakening, generalised tonic-clonic seizures, typical absences and usually presents for the first time at the age of 12 to 18 years old. This article describes the results of a clinical study into JME phenotypes in patients living in the Siberian Federal District. We have shown that the incidence of JME among males was lower than among females (1:1.9) and JME debut age for males was higher than in those women. Classical phenotype of JME (Type I) was dominant and more common in males compared to females—70.4% vs. 58.5%, respectively. The JME phenotype with worse prognosis in terms of achieving stable clinical remission (Type II) occurred 3.5 times more frequently among female patients compared to male (13.2% vs. 3.7% respectively). The findings resulting from this study give a deeper insight into the diagnosis and prognosis of this form of idiopathic generalised epilepsy in predisposed families.展开更多
Juvenile myoclonic epilepsy (JME) is one of the most common types of idiopathic generalised epilepsy. It starts in teenage years, yet it is frequently misdiagnosed or diagnosed very late, thereby resulting in inadequa...Juvenile myoclonic epilepsy (JME) is one of the most common types of idiopathic generalised epilepsy. It starts in teenage years, yet it is frequently misdiagnosed or diagnosed very late, thereby resulting in inadequate therapy plan and worsening of symptoms. Timely diagnosis of JME is crucial for the correct management of symptoms and prevention of disease development. In this case report we describe a case of a 33-year-old woman who did not receive appropriate care due to a late diagnosis of her JME condition.展开更多
癫痫伴肌阵挛-失张力发作(epilepsy with myoclonic-atonic seizures,EMAS)既往称为肌阵挛-站立不能性癫痫(myoclonic-astatic epilepsy)或肌阵挛-失张力癫痫(myoclonic-atonic epilepsy,MAE)。EMAS是1970年由德国医生Doose等首次报道,...癫痫伴肌阵挛-失张力发作(epilepsy with myoclonic-atonic seizures,EMAS)既往称为肌阵挛-站立不能性癫痫(myoclonic-astatic epilepsy)或肌阵挛-失张力癫痫(myoclonic-atonic epilepsy,MAE)。EMAS是1970年由德国医生Doose等首次报道,所以也被称为Doose综合征[1]。2010年国际抗癫痫联盟(International League Against Epilepsy,ILAE)将本病更名为癫痫伴肌阵挛-失张力发作,是一种以常染色体显性遗传的罕见的癫痫综合征,EMAS占儿童期癫痫的0.3%~2.2%,通常发病于7个月~6岁,癫痫发作类型包括肌阵挛-失张力、失张力、肌阵挛、全身性强直-阵挛、失神和强直性癫痫发作。脑电图(EEG)可能表现出不规则的广义棘波或多棘波复合波。展开更多
文摘Description： The progressive myoclonus epilepsies （PME＇s） comprise a large group of genetically determined disorders characterized by myoclonus, generalized tonic-clonic seizures, cerebellar dysfunction and variable degrees of cognitive impairment.
基金Key Research Project of the Ministry of Scienceand Technology of China(grant numbers 2016YFC0904400 and2016YFC0904401)The capital health research and development of special(grant number 2016–1-2011).
文摘Background:Progressive myoclonic epilepsy(PME)is a group of neurodegenerative diseases with genetic heterogeneity and phenotypic similarities,and many cases remain unknown of the genetic causes.This study is aim to summarize the clinical features and study the genetic causes of PME patients.Methods:Sanger sequencing of the target gene,Next Generation Sequencing(NGS)panels of epilepsy,trio-based Whole Exome Sequencing(WES)and detection of cytosine-adenine-guanine(CAG)repeat number were used to investigate the genetic causes of PME patients.Results:Thirty-eight children with PME whose seizure onset age ranged from 3 months to 12 years were collected from February 2012 to November 2019 in three hospitals in Beijing,China.The seizure types included myoclonic seizures(n=38),focal seizures(n=19),generalized tonic-clonie seizure(GTCS)(n=13),absence seizures(n=4),atonic seizures(n=3),epileptic spasms(n=2)and tonic seizures(n=1).Twenty-seven cases were sporadic and 11 had family members affected.Established PME-related genes were identified in 30 out of 38(78.9%)patients who had either recessively inherited or de novo heterozygous mutations.Among these 30 cases,there were 12 cases(31.6%)of neuronal ceroid lipofuscinoses(the causing gene contains TPP1,PPT1,CLN5,CLN6 and MFSD8),two cases of sialidosis(the causing gene is NEU1),two cases of neuronopathic Gaucher disease(the causing gene is GBA),one case of spinal muscular atrophy-progressive myoclonic epilepsy(the causing gene is ASAH1),four cases of KCNC1 mutation-related PME,four cases of KCTD7 mutation-related PME,two cases of TBC1D24 mutation-related PME,one case of GOSR2 related PME,and two of dentatorubral-pallidoluysian atrophy(the causing gene is ATN1).In total,13 PME genes were identified in our cohort.The etiology was not clear in eight patients.Conclusion:PME is a group of clinically and genetically heterogeneous diseases.Genetic diagnosis was clear in 78.9%of PME patients.Various of genetic testing methods could increase the rate of genetic diagnosis.Neuronal ceroid lipofuscinoses(NCL)is the most common etiology of PME in children.Nearly one third PME children were diagnosed with NCL.GOSR2 related PME was in our cohort in Asia for the first time.
基金This work was supported by the grants from the National Natural Science Foundation of China （No. U1505222, No, 81322017, No. 81500980, and No. 81571100） and the National Key Clinical Specialty Discipline Construction Program and Key Clinical Specialty Discipline Construction Program of Fujian.
文摘Background： Progressive myoclonus epilepsies （PMEs） conaprise a group of rare genetic disorders characterized by action rnyoclonus, epileptic seizures, and ataxia with progressive neurologic decline. Due to clinical and genetic heterogeneity of PMEs, it is difficult to decide which genes are affected. The aim of this study was to report an action myoclonus with or without renal failure syndrome （EPM4） fhmily and summarize the clinical and genetic characteristics of all reported EPM4 patients. Meihods： In the present study, targeted next-generation sequencing （NGS） was applied to screen causative genes in a Chinese PME family. The candidaie variant was further confirmed by cosegregation analysis and further functional analysis, including the reverse transcription polymerase chain reaction and Western blot of the proband＇s muscle. Moreovel, literature data on the clinical and mutational features of all reported EPM4 patients were reviewed. Results： The gene analysis revealed a novel homozygous splicing mutation （c.995-1G〉A） of the SCARB2 gene in two brothers. Further functional analysis revealed that this mutation led to loss function of the SCARB2 protein. The classification of the candidate variant, according to the American College of Medical Genetics and Genomics standards and guidelines and functional analysis, was pathogenic. Therefore, these two brothers were finally diagnostically confirmed as EPM4. Conclusions： These present results suggest the potential for targeted NGS to conduct a more rapid and precise diagnosis for PME patients. A literature review revealed that mutations in the different functional domains of SCARB2 appear to be associated with the phenotype of EPM4.
文摘目的为临床合理使用拉莫三嗪(LTG)提供参考。方法检索中国知网、万方、维普、PubMed、Web of Science数据库自建库起至2023年11月的LTG治疗药物监测相关文献,从治疗窗、药物代谢动力学(简称药动学)特征,特殊人群(妊娠期女性、儿童、老年人等)药动学特征及代谢酶相关基因多态性对血药浓度的影响等方面,总结LTG治疗药物监测研究进展。结果LTG是治疗癫痫发作和双相情感障碍的药物,临床应用时需参考最新治疗窗;临床监测样本以血浆为主,头发和唾液也可作为非入侵样本;血药浓度检测的主要方法为液相色谱法,荧光光谱法和电化学传感器正逐渐被应用。LTG生物利用度约为98%,蛋白质结合率约为55%,达峰时间不受给药剂量限制;在与其他药物联用时要注意调整剂量。有潜在生育能力的癫痫女性用药首选LTG,用于老年癫痫时更适用于新发患者,对于癫痫患儿应重点监测血药浓度,以避免发生不良反应。尿苷5'-二磷酸-葡萄糖醛酸糖基转移酶是参与LTG代谢的主要酶,其相关基因的多态性也是血药浓度的重要影响因素。结论应采用合适的样本和方法检测LTG血药浓度,并关注不同人群及不同基因型,以预防严重不良反应的发生。
文摘Juvenile myoclonic epilepsy (JME) is characterised by myoclonia during awakening, generalised tonic-clonic seizures, typical absences and usually presents for the first time at the age of 12 to 18 years old. This article describes the results of a clinical study into JME phenotypes in patients living in the Siberian Federal District. We have shown that the incidence of JME among males was lower than among females (1:1.9) and JME debut age for males was higher than in those women. Classical phenotype of JME (Type I) was dominant and more common in males compared to females—70.4% vs. 58.5%, respectively. The JME phenotype with worse prognosis in terms of achieving stable clinical remission (Type II) occurred 3.5 times more frequently among female patients compared to male (13.2% vs. 3.7% respectively). The findings resulting from this study give a deeper insight into the diagnosis and prognosis of this form of idiopathic generalised epilepsy in predisposed families.
文摘Juvenile myoclonic epilepsy (JME) is one of the most common types of idiopathic generalised epilepsy. It starts in teenage years, yet it is frequently misdiagnosed or diagnosed very late, thereby resulting in inadequate therapy plan and worsening of symptoms. Timely diagnosis of JME is crucial for the correct management of symptoms and prevention of disease development. In this case report we describe a case of a 33-year-old woman who did not receive appropriate care due to a late diagnosis of her JME condition.
文摘癫痫伴肌阵挛-失张力发作(epilepsy with myoclonic-atonic seizures,EMAS)既往称为肌阵挛-站立不能性癫痫(myoclonic-astatic epilepsy)或肌阵挛-失张力癫痫(myoclonic-atonic epilepsy,MAE)。EMAS是1970年由德国医生Doose等首次报道,所以也被称为Doose综合征[1]。2010年国际抗癫痫联盟(International League Against Epilepsy,ILAE)将本病更名为癫痫伴肌阵挛-失张力发作,是一种以常染色体显性遗传的罕见的癫痫综合征,EMAS占儿童期癫痫的0.3%~2.2%,通常发病于7个月~6岁,癫痫发作类型包括肌阵挛-失张力、失张力、肌阵挛、全身性强直-阵挛、失神和强直性癫痫发作。脑电图(EEG)可能表现出不规则的广义棘波或多棘波复合波。
