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Abraham A, Ramsey K, Belnap N, Szelinger S, Jepsen W, Balak C, Sanchez-Castillo M, Naymik M, Bonfitto A, Rangasamy S, Kruglyak S, Huentelman M, Narayanan V. FGF12 copy number variant associated with epileptic encephalopathy. Clin Genet 2024; 106:114-115. [PMID: 38715525 DOI: 10.1111/cge.14542] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2024] [Revised: 04/23/2024] [Accepted: 04/25/2024] [Indexed: 06/04/2024]
Abstract
FGF12 related epilepsy presents with variable phenotypes. We report another patient with a duplication involving the FGF12 gene who presented similar to other published cases having normal early development and responded to phenytoin.
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Affiliation(s)
- Anna Abraham
- Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Keri Ramsey
- Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Newell Belnap
- Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Szabolcs Szelinger
- Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Wayne Jepsen
- Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Chris Balak
- Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Meredith Sanchez-Castillo
- Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Marcus Naymik
- Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Anna Bonfitto
- Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Sampathkumar Rangasamy
- Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | | | - Matthew Huentelman
- Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
| | - Vinodh Narayanan
- Center for Rare Childhood Disorders, Translational Genomics Research Institute, Phoenix, Arizona, USA
- Neurogenomics Division, Translational Genomics Research Institute, Phoenix, Arizona, USA
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2
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Saleem NM, Chencheri N, Thomas S, Alexander G, Madathil B. Early-Onset Epileptic Encephalopathy Responsive to Phenytoin: A Diagnostic Clue for Fibroblast Growth Factor 12 Mutation. Cureus 2024; 16:e53906. [PMID: 38465135 PMCID: PMC10924931 DOI: 10.7759/cureus.53906] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 02/09/2024] [Indexed: 03/12/2024] Open
Abstract
We present a case of a three-year-old girl with a rare genetic epilepsy with developmental delay. She was born to a non-consanguineous parentage and required resuscitation soon after delivery via cesarean section. The patient had her first seizure within 36 hours of life, which progressed into refractory epilepsy. She required multiple hospital admissions due to prolonged seizures. Despite being tried on multiple drug combinations over the years, she responded only to phenytoin. Basic imaging and other investigations, including genetic analysis, revealed a fibroblast growth factor 12 (FGF12) mutation. Mutations in these genes cause refractory early-onset seizures associated with severe developmental delay. Due to early and appropriate intervention with phenytoin, she had good seizure control which probably resulted in a better developmental outcome.
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Affiliation(s)
- Nadia M Saleem
- Department of Medicine and Surgery, Dubai Academic Health Corporation, Dubai, ARE
| | - Nidheesh Chencheri
- Department of Pediatric Neurology, Al Jalila Children's Specialty Hospital, Dubai, ARE
| | - Sen Thomas
- Department of Pediatric Emergency Medicine, Al Jalila Children's Specialty Hospital, Dubai, ARE
| | - Gail Alexander
- Department of Pediatric Neurology, Al Jalila Children's Specialty Hospital, Dubai, ARE
| | - Biju Madathil
- Department of Neonatology, NMC Royal Women's Hospital, Abu Dhabi, ARE
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3
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Modulating effects of FGF12 variants on Na V1.2 and Na V1.6 being associated with developmental and epileptic encephalopathy and Autism spectrum disorder: A case series. EBioMedicine 2022; 83:104234. [PMID: 36029553 PMCID: PMC9429545 DOI: 10.1016/j.ebiom.2022.104234] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/09/2021] [Revised: 08/05/2022] [Accepted: 08/05/2022] [Indexed: 01/18/2023] Open
Abstract
OBJECTIVE Fibroblast Growth Factor 12 (FGF12) may represent an important modulator of neuronal network activity and has been associated with developmental and epileptic encephalopathy (DEE). We sought to identify the underlying pathomechanism of FGF12-related disorders. METHODS Patients with pathogenic variants in FGF12 were identified through published case reports, GeneMatcher and whole exome sequencing of own case collections. The functional consequences of two missense and two copy number variants (CNVs) were studied by co-expression of wildtype and mutant FGF12 in neuronal-like cells (ND7/23) with the sodium channels NaV1.2 or NaV1.6, including their beta-1 and beta-2 sodium channel subunits (SCN1B and SCN2B). RESULTS Four variants in FGF12 were identified for functional analysis: one novel FGF12 variant in a patient with autism spectrum disorder and three variants from previously published patients affected by DEE. We demonstrate the differential regulating effects of wildtype and mutant FGF12 on NaV1.2 and NaV1.6 channels. Here, FGF12 variants lead to a complex kinetic influence on NaV1.2 and NaV1.6, including loss- as well as gain-of function changes in fast and slow inactivation. INTERPRETATION We could demonstrate the detailed regulating effect of FGF12 on NaV1.2 and NaV1.6 and confirmed the complex effect of FGF12 on neuronal network activity. Our findings expand the phenotypic spectrum related to FGF12 variants and elucidate the underlying pathomechanism. Specific variants in FGF12-associated disorders may be amenable to precision treatment with sodium channel blockers. FUNDING DFG, BMBF, Hartwell Foundation, National Institute for Neurological Disorders and Stroke, IDDRC, ENGIN, NIH, ITMAT, ILAE, RES and GRIN.
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Tian Q, Li H, Shu L, Wang H, Peng Y, Fang H, Mao X. Effective treatments for FGF12-related early-onset epileptic encephalopathies patients. Brain Dev 2021; 43:851-856. [PMID: 34020858 DOI: 10.1016/j.braindev.2021.04.010] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/24/2020] [Revised: 04/26/2021] [Accepted: 04/26/2021] [Indexed: 11/19/2022]
Abstract
BACKGROUND FGF12 (FHF1) gene encodes voltage-gated sodium channel (Nav)-binding protein fibroblast growth factor homologous factor 1, which could cause seizures by regulating voltage dependence of Nav fast inactivation and neuron excitability. The most common pathogenic variant FGF12 c.341G > A related early-onset epileptic encephalopathies (EOEE) was characterized by intractable seizures and developmental disabilities. RESULTS Using whole exome sequencing, a de novo hotspot variant c.341G > A (NM_021032.4) of FGF12 was identified in three unrelated EOEE probands. All probands were seizure free after a combination treatment of valproic acid (VPA) and topiramate (TPM). The motor and cognitive skills in two probands were improved due to the early and effective treatment. In order to compare the effectiveness of different treatment strategies for the disease, a review of treatments for FGF12-related epilepsy was made. CONCLUSION We reported three FGF12 c.341G > A related EOEE patients responded well to a combination antiepileptic therapy of VPA and TPM. The current study is the first to describe the combination therapy of VPA and TPM in FGF12 c.341G > A related EOEE patients. This study may contribute to future medication consultation for intractable epilepsy with FGF12 hotspot variants.
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Affiliation(s)
- Qi Tian
- Department of Medical Genetics, Maternal, Child Health Hospital of Hunan Province, Changsha Hunan 410008, China; National Health Commission Key Laboratory of Birth Defects Research, Prevention and Treatment, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, China
| | - Haoyu Li
- Department of Neurosurgery, Xiangya Hospital, Central South University, Changsha 410008, China; Center for Molecular Medicine, Xiangya Hospital, Central South University, Changsha 410008, China
| | - Li Shu
- Department of Medical Genetics, Maternal, Child Health Hospital of Hunan Province, Changsha Hunan 410008, China; National Health Commission Key Laboratory of Birth Defects Research, Prevention and Treatment, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, China
| | - Hua Wang
- Department of Medical Genetics, Maternal, Child Health Hospital of Hunan Province, Changsha Hunan 410008, China; National Health Commission Key Laboratory of Birth Defects Research, Prevention and Treatment, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, China
| | - Ying Peng
- Department of Medical Genetics, Maternal, Child Health Hospital of Hunan Province, Changsha Hunan 410008, China.
| | - Hongjun Fang
- Department of Neurology, Hunan Children's Hospital, University of South China, Changsha 410007, China.
| | - Xiao Mao
- Department of Medical Genetics, Maternal, Child Health Hospital of Hunan Province, Changsha Hunan 410008, China; National Health Commission Key Laboratory of Birth Defects Research, Prevention and Treatment, Hunan Provincial Maternal and Child Health Care Hospital, Changsha 410008, China.
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5
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Fry AE, Marra C, Derrick AV, Pickrell WO, Higgins AT, Te Water Naude J, McClatchey MA, Davies SJ, Metcalfe KA, Tan HJ, Mohanraj R, Avula S, Williams D, Brady LI, Mesterman R, Tarnopolsky MA, Zhang Y, Yang Y, Wang X, Rees MI, Goldfarb M, Chung SK. Missense variants in the N-terminal domain of the A isoform of FHF2/FGF13 cause an X-linked developmental and epileptic encephalopathy. Am J Hum Genet 2021; 108:176-185. [PMID: 33245860 PMCID: PMC7820623 DOI: 10.1016/j.ajhg.2020.10.017] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/12/2020] [Accepted: 10/30/2020] [Indexed: 01/22/2023] Open
Abstract
Fibroblast growth factor homologous factors (FHFs) are intracellular proteins which regulate voltage-gated sodium (Nav) channels in the brain and other tissues. FHF dysfunction has been linked to neurological disorders including epilepsy. Here, we describe two sibling pairs and three unrelated males who presented in infancy with intractable focal seizures and severe developmental delay. Whole-exome sequencing identified hemi- and heterozygous variants in the N-terminal domain of the A isoform of FHF2 (FHF2A). The X-linked FHF2 gene (also known as FGF13) has alternative first exons which produce multiple protein isoforms that differ in their N-terminal sequence. The variants were located at highly conserved residues in the FHF2A inactivation particle that competes with the intrinsic fast inactivation mechanism of Nav channels. Functional characterization of mutant FHF2A co-expressed with wild-type Nav1.6 (SCN8A) revealed that mutant FHF2A proteins lost the ability to induce rapid-onset, long-term blockade of the channel while retaining pro-excitatory properties. These gain-of-function effects are likely to increase neuronal excitability consistent with the epileptic potential of FHF2 variants. Our findings demonstrate that FHF2 variants are a cause of infantile-onset developmental and epileptic encephalopathy and underline the critical role of the FHF2A isoform in regulating Nav channel function.
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Affiliation(s)
- Andrew E Fry
- Institute of Medical Genetics, University Hospital of Wales, Cardiff CF14 4XW, UK; Division of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK.
| | - Christopher Marra
- Department of Biological Sciences, Hunter College of City University, 695 Park Avenue, New York, NY 10065, USA; Program in Biology, Graduate Center of City University, 365 Fifth Avenue, New York, NY 10016, USA
| | - Anna V Derrick
- Neurology and Molecular Neuroscience Research, Institute of Life Science, Swansea University Medical School, Swansea University, Swansea SA2 8PP, UK
| | - William O Pickrell
- Neurology and Molecular Neuroscience Research, Institute of Life Science, Swansea University Medical School, Swansea University, Swansea SA2 8PP, UK; Neurology department, Morriston Hospital, Swansea Bay University Hospital Health Board, Swansea SA6 6NL, UK
| | - Adam T Higgins
- Neurology and Molecular Neuroscience Research, Institute of Life Science, Swansea University Medical School, Swansea University, Swansea SA2 8PP, UK
| | - Johann Te Water Naude
- Paediatric Neurology, University Hospital of Wales, Heath Park, Cardiff CF14 4XW, UK
| | - Martin A McClatchey
- Division of Cancer and Genetics, School of Medicine, Cardiff University, Cardiff CF14 4XN, UK
| | - Sally J Davies
- Institute of Medical Genetics, University Hospital of Wales, Cardiff CF14 4XW, UK
| | - Kay A Metcalfe
- Manchester Centre for Genomic Medicine, Manchester University NHS Foundation Trust and Institute of Human Development, University of Manchester, Manchester M13 9WL, UK
| | - Hui Jeen Tan
- Department of Paediatric Neurology, Royal Manchester Children's Hospital, Oxford Road, Manchester M13 9WL, UK
| | - Rajiv Mohanraj
- Department of Neurology, Salford Royal Hospital NHS Foundation Trust, Stott Lane, Salford M6 8HD, UK
| | - Shivaram Avula
- Department of Radiology, Alder Hey Children's NHS Foundation Trust, Eaton Road, Liverpool L12 2AP, UK
| | - Denise Williams
- West Midlands Regional Genetics Service, Clinical Genetics Unit, Birmingham Women's Hospital, Birmingham B15 2TG, UK
| | - Lauren I Brady
- Department of Paediatrics, McMaster University, 1200 Main St. W., Hamilton, ON L8N 3Z5, Canada
| | - Ronit Mesterman
- Department of Paediatrics, McMaster University, 1200 Main St. W., Hamilton, ON L8N 3Z5, Canada
| | - Mark A Tarnopolsky
- Department of Paediatrics, McMaster University, 1200 Main St. W., Hamilton, ON L8N 3Z5, Canada
| | - Yuehua Zhang
- Department of Pediatrics, Peking University First Hospital, Xicheng District, Beijing 100034, China
| | - Ying Yang
- Department of Pediatrics, Peking University First Hospital, Xicheng District, Beijing 100034, China
| | | | - Mark I Rees
- Neurology and Molecular Neuroscience Research, Institute of Life Science, Swansea University Medical School, Swansea University, Swansea SA2 8PP, UK; Faculty of Medicine and Health, Camperdown, University of Sydney, NSW 2006, Australia
| | - Mitchell Goldfarb
- Department of Biological Sciences, Hunter College of City University, 695 Park Avenue, New York, NY 10065, USA; Program in Biology, Graduate Center of City University, 365 Fifth Avenue, New York, NY 10016, USA
| | - Seo-Kyung Chung
- Neurology and Molecular Neuroscience Research, Institute of Life Science, Swansea University Medical School, Swansea University, Swansea SA2 8PP, UK; Kids Neuroscience Centre, Kids Research, Children Hospital at Westmead, Sydney, NSW 2145, Australia; Brain and Mind Centre, Faculty of Medicine and Health, University of Sydney, NSW 2050, Australia
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6
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Kim SY, Jang SS, Kim H, Hwang H, Choi JE, Chae JH, Kim KJ, Lim BC. Genetic diagnosis of infantile-onset epilepsy in the clinic: Application of whole-exome sequencing following epilepsy gene panel testing. Clin Genet 2021; 99:418-424. [PMID: 33349918 DOI: 10.1111/cge.13903] [Citation(s) in RCA: 13] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2020] [Revised: 12/02/2020] [Accepted: 12/17/2020] [Indexed: 12/11/2022]
Abstract
This study aimed to evaluate the clinical utility of whole-exome sequencing in a group of infantile-onset epilepsy patients who tested negative for epilepsy using a gene panel test. Whole-exome sequencing was performed on 59 patients who tested negative on customized epilepsy gene panel testing. We identified eight pathogenic or likely pathogenic sequence variants in eight different genes (FARS2, YWHAG, KCNC1, DYRK1A, SMC1A, PIGA, OGT, and FGF12), one pathogenic structural variant (8.6 Mb-sized deletion on chromosome X [140 994 419-149 630 805]), and three putative low-frequency mosaic variants from three different genes (GABBR2, MTOR, and CUX1). Subsequent whole-exome sequencing revealed an additional 8% of diagnostic yield with genetic confirmation of epilepsy in 55.4% (62/112) of our cohort. Three genes (YWHAG, KCNC1, and FGF12) were identified as epilepsy-causing genes after the original gene panel was designed. The others were initially linked with mitochondrial encephalopathy or different neurodevelopmental disorders, although an epilepsy phenotype was listed as one of the clinical features. Application of whole-exome sequencing following epilepsy gene panel testing provided 8% of additional diagnostic yield in an infantile-onset epilepsy cohort. Whole-exome sequencing could provide an opportunity to reanalyze newly recognized epilepsy-linked genes without updating the gene panel design.
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Affiliation(s)
- Soo Yeon Kim
- Department of Pediatrics, Pediatric Neuroscience Center, Seoul National University Children's Hospital, Seoul National University Children's Hospital, Seoul, South Korea.,Rare Diseases Center, Seoul National University Hospital, Seoul, South Korea
| | - Se Song Jang
- Department of Pediatrics, Pediatric Neuroscience Center, Seoul National University Children's Hospital, Seoul National University Children's Hospital, Seoul, South Korea
| | - Hunmin Kim
- Department of Pediatrics, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea
| | - Hee Hwang
- Department of Pediatrics, Seoul National University Bundang Hospital, Gyeonggi-do, South Korea
| | - Ji Eun Choi
- Department of Pediatrics, Seoul National University Boramae Medical Center, Seoul, South Korea
| | - Jong-Hee Chae
- Department of Pediatrics, Pediatric Neuroscience Center, Seoul National University Children's Hospital, Seoul National University Children's Hospital, Seoul, South Korea.,Rare Diseases Center, Seoul National University Hospital, Seoul, South Korea.,Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Ki Joong Kim
- Department of Pediatrics, Pediatric Neuroscience Center, Seoul National University Children's Hospital, Seoul National University Children's Hospital, Seoul, South Korea.,Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
| | - Byung Chan Lim
- Department of Pediatrics, Pediatric Neuroscience Center, Seoul National University Children's Hospital, Seoul National University Children's Hospital, Seoul, South Korea.,Rare Diseases Center, Seoul National University Hospital, Seoul, South Korea.,Department of Pediatrics, Seoul National University College of Medicine, Seoul, South Korea
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7
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Verheyen S, Speicher MR, Ramler B, Plecko B. Childhood-onset epileptic encephalopathy due to FGF12 exon 1-4 tandem duplication. NEUROLOGY-GENETICS 2020; 6:e494. [PMID: 32802954 PMCID: PMC7371371 DOI: 10.1212/nxg.0000000000000494] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 05/15/2020] [Indexed: 11/15/2022]
Affiliation(s)
- Sarah Verheyen
- Institute of Human Genetics (S.V., M.R.S., B.R.), Diagnostic and Research Center for MolecularBioMedicine, Medical University of Graz; and Department of Pediatrics and Adolescent Medicine (B.P.), Division of General Pediatrics, Medical University of Graz, Austria
| | - Michael R Speicher
- Institute of Human Genetics (S.V., M.R.S., B.R.), Diagnostic and Research Center for MolecularBioMedicine, Medical University of Graz; and Department of Pediatrics and Adolescent Medicine (B.P.), Division of General Pediatrics, Medical University of Graz, Austria
| | - Barbara Ramler
- Institute of Human Genetics (S.V., M.R.S., B.R.), Diagnostic and Research Center for MolecularBioMedicine, Medical University of Graz; and Department of Pediatrics and Adolescent Medicine (B.P.), Division of General Pediatrics, Medical University of Graz, Austria
| | - Barbara Plecko
- Institute of Human Genetics (S.V., M.R.S., B.R.), Diagnostic and Research Center for MolecularBioMedicine, Medical University of Graz; and Department of Pediatrics and Adolescent Medicine (B.P.), Division of General Pediatrics, Medical University of Graz, Austria
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8
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Trivisano M, Ferretti A, Bebin E, Huh L, Lesca G, Siekierska A, Takeguchi R, Carneiro M, De Palma L, Guella I, Haginoya K, Shi RM, Kikuchi A, Kobayashi T, Jung J, Lagae L, Milh M, Mathieu ML, Minassian BA, Novelli A, Pietrafusa N, Takeshita E, Tartaglia M, Terracciano A, Thompson ML, Cooper GM, Vigevano F, Villard L, Villeneuve N, Buyse GM, Demos M, Scheffer IE, Specchio N. Defining the phenotype of FHF1 developmental and epileptic encephalopathy. Epilepsia 2020; 61:e71-e78. [PMID: 32645220 DOI: 10.1111/epi.16582] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2020] [Revised: 05/18/2020] [Accepted: 05/26/2020] [Indexed: 01/25/2023]
Abstract
Fibroblast growth-factor homologous factor (FHF1) gene variants have recently been associated with developmental and epileptic encephalopathy (DEE). FHF1 encodes a cytosolic protein that modulates neuronal sodium channel gating. We aim to refine the electroclinical phenotypic spectrum of patients with pathogenic FHF1 variants. We retrospectively collected clinical, genetic, neurophysiologic, and neuroimaging data of 17 patients with FHF1-DEE. Sixteen patients had recurrent heterozygous FHF1 missense variants: 14 had the recurrent p.Arg114His variant and two had a novel likely pathogenic variant p.Gly112Ser. The p.Arg114His variant is associated with an earlier onset and more severe phenotype. One patient carried a chromosomal microduplication involving FHF1. Twelve patients carried a de novo variant, five (29.5%) inherited from parents with gonadic or somatic mosaicism. Seizure onset was between 1 day and 41 months; in 76.5% it was within 30 days. Tonic seizures were the most frequent seizure type. Twelve patients (70.6%) had drug-resistant epilepsy, 14 (82.3%) intellectual disability, and 11 (64.7%) behavioral disturbances. Brain magnetic resonance imaging (MRI) showed mild cerebral and/or cerebellar atrophy in nine patients (52.9%). Overall, our findings expand and refine the clinical, EEG, and imaging phenotype of patients with FHF1-DEE, which is characterized by early onset epilepsy with tonic seizures, associated with moderate to severe ID and psychiatric features.
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Affiliation(s)
- Marina Trivisano
- Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital IRCCS, Member of European Reference Network EpiCARE, Rome, Italy
| | - Alessandro Ferretti
- Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital IRCCS, Member of European Reference Network EpiCARE, Rome, Italy
| | - Elizabeth Bebin
- Department of Pediatric Neurology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Linda Huh
- Division of Neurology, Department of Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada
| | - Gaetan Lesca
- Service de Génétique, Hospices Civils de Lyon, Lyon, France.,Institut Neuromyogène, Equipe Métabolisme énergétique et développement neuronal, CNRS, UMR 5310, INSERM U1217, Université Lyon 1, Lyon, France
| | | | - Ryo Takeguchi
- Department of Pediatrics, Asahikawa Medical University, Asahikawa, Japan
| | - Maryline Carneiro
- Department of Pediatric Neurology, Femme Mère Enfant Hospital, Hospices Civils de Lyon, Lyon, France
| | - Luca De Palma
- Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital IRCCS, Member of European Reference Network EpiCARE, Rome, Italy
| | - Ilaria Guella
- Division of Neurology, Department of Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada
| | - Kazuhiro Haginoya
- Department of Pediatric Neurology, Miyagi Children's Hospital, Sendai, Japan
| | - Ruo Ming Shi
- Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan.,Department of Pediatrics, First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China
| | - Atsuo Kikuchi
- Department of Pediatrics, Tohoku University Hospital, Sendai, Japan
| | - Tomoko Kobayashi
- Division of Child Development, Department of Preventive Medicine and Epidemiology, Tohoku Medical Megabank Organization, Tohoku University, Sendai, Japan
| | - Julien Jung
- Service de Génétique, Hospices Civils de Lyon, Lyon, France.,Institut Neuromyogène, Equipe Métabolisme énergétique et développement neuronal, CNRS, UMR 5310, INSERM U1217, Université Lyon 1, Lyon, France
| | - Lieven Lagae
- Department of Development and Regeneration, University Hospitals KU Leuven, Leuven, Belgium
| | - Mathieu Milh
- Department of Pediatric Neurology, Femme Mère Enfant Hospital, Hospices Civils de Lyon, Lyon, France
| | - Marie L Mathieu
- Department of Pediatric Neurology, Femme Mère Enfant Hospital, Hospices Civils de Lyon, Lyon, France
| | - Berge A Minassian
- Department of Pediatrics, University of Texas Southwestern, Dallas, TX, USA
| | - Antonio Novelli
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Nicola Pietrafusa
- Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital IRCCS, Member of European Reference Network EpiCARE, Rome, Italy
| | - Eri Takeshita
- Department of Child Neurology, National Center Hospital, National Center of Neurology and Psychiatry, Tokyo, Japan
| | - Marco Tartaglia
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | - Alessandra Terracciano
- Genetics and Rare Diseases Research Division, Bambino Gesù Children's Hospital IRCCS, Rome, Italy
| | | | | | - Federico Vigevano
- Department of Neuroscience, Bambino Gesù Children's Hospital IRCCS, Member of European Reference Network EpiCARE, Rome, Italy
| | | | - Nathalie Villeneuve
- Department of Pediatric Neurology, APHM, Hopital de la Timone, Marseille, France
| | - Gunnar M Buyse
- Pediatric Neurology, University Hospitals Leuven, Leuven, Belgium
| | - Michelle Demos
- Division of Neurology, Department of Pediatrics, University of British Columbia and BC Children's Hospital, Vancouver, BC, Canada
| | - Ingrid E Scheffer
- Austin Health, and Royal Children's Hospital, Florey and Murdoch Institutes, University of Melbourne, Melbourne, Australia
| | - Nicola Specchio
- Rare and Complex Epilepsy Unit, Department of Neuroscience, Bambino Gesù Children's Hospital IRCCS, Member of European Reference Network EpiCARE, Rome, Italy
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9
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Willemsen MH, Goel H, Verhoeven JS, Braakman HMH, de Leeuw N, Freeth A, Minassian BA. Epilepsy phenotype in individuals with chromosomal duplication encompassing FGF12. Epilepsia Open 2020; 5:301-306. [PMID: 32524056 PMCID: PMC7278552 DOI: 10.1002/epi4.12396] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/31/2019] [Revised: 03/03/2020] [Accepted: 03/16/2020] [Indexed: 11/11/2022] Open
Abstract
Intragenic mutations in FGF12 are associated with intractable seizures, developmental regression, intellectual disability, ataxia, hypotonia, and feeding difficulties. FGF12 duplications are rarely reported, but it was suggested that those might have a similar gain-of-function effect and lead to a more or less comparable phenotype. A favorable response to the sodium blocker phenytoin was reported in several cases, both in patients with an intragenic mutation and in patients with a duplication of FGF12. We report three individuals from two families with FGF12 duplications. The duplications are flanked and probably mediated by two long interspersed nuclear elements (LINEs). The duplication cases show phenotypic overlap with the cases with intragenic mutations. Though the onset of epilepsy might be later, after the onset of seizures both groups show developmental stagnation and regression in several cases. This illustrates and further confirms that chromosomal FGF12 duplications and intragenic gain-of-function mutations yield overlapping phenotypes.
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Affiliation(s)
- Marjolein H Willemsen
- Department of Clinical Genetics Maastricht University Medical Centre Maastricht The Netherlands.,Department of Human Genetics Radboud University Medical Center Nijmegen The Netherlands.,Donders Institute for Brain Cognition and Behaviour Radboud University Nijmegen The Netherlands
| | - Himanshu Goel
- Hunter Genetics Waratah NSW Australia.,University of Newcastle Callaghan NSW Australia
| | - Judith S Verhoeven
- Department of Neurology Academic Center for Epileptology Kempenhaeghe and Maastricht UMC+ Heeze The Netherlands
| | - Hilde M H Braakman
- Donders Institute for Brain Cognition and Behaviour Radboud University Nijmegen The Netherlands.,Department of Pediatric Neurology Amalia Children's Hospital Radboud University Medical Center Nijmegen The Netherlands
| | - Nicole de Leeuw
- Department of Human Genetics Radboud University Medical Center Nijmegen The Netherlands.,Donders Institute for Brain Cognition and Behaviour Radboud University Nijmegen The Netherlands
| | - Alison Freeth
- Hunter Genetics Waratah NSW Australia.,University of Newcastle Callaghan NSW Australia
| | - Berge A Minassian
- Program in Genetics and Genome Biology Hospital for Sick Children Research Institute Toronto ON Canada.,Institute of Medical Science University of Toronto Toronto ON Canada.,Division of Neurology Department of Pediatrics University of Texas Southwestern Dallas TX USA
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10
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Paprocka J, Jezela‐Stanek A, Koppolu A, Rydzanicz M, Kosińska J, Stawiński P, Płoski R. FGF12
p.Gly112Ser variant as a cause of phenytoin/phenobarbital responsive epilepsy. Clin Genet 2019; 96:274-275. [DOI: 10.1111/cge.13592] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2019] [Revised: 06/19/2019] [Accepted: 06/20/2019] [Indexed: 11/29/2022]
Affiliation(s)
- Justyna Paprocka
- Department of Paediatric NeurologySchool of Medicine in Katowice, Medical University of Silesia in Katowice Katowice Poland
| | - Aleksandra Jezela‐Stanek
- Department of Genetics and Clinical ImmunologyNational Institute of Tuberculosis and Lung Diseases Warsaw Poland
| | - Agniesz Koppolu
- Department of Medical GeneticsWarsaw Medical University Warsaw Poland
- Postgraduate School of Molecular MedicineWarsaw Medical University Warsaw Poland
| | | | - Joanna Kosińska
- Department of Medical GeneticsWarsaw Medical University Warsaw Poland
| | - Piotr Stawiński
- Department of Medical GeneticsWarsaw Medical University Warsaw Poland
| | - Rafał Płoski
- Department of Medical GeneticsWarsaw Medical University Warsaw Poland
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11
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Coppola A, Cellini E, Stamberger H, Saarentaus E, Cetica V, Lal D, Djémié T, Bartnik‐Glaska M, Ceulemans B, Helen Cross J, Deconinck T, Masi SD, Dorn T, Guerrini R, Hoffman‐Zacharska D, Kooy F, Lagae L, Lench N, Lemke JR, Lucenteforte E, Madia F, Mefford HC, Morrogh D, Nuernberg P, Palotie A, Schoonjans A, Striano P, Szczepanik E, Tostevin A, Vermeesch JR, Van Esch H, Van Paesschen W, Waters JJ, Weckhuysen S, Zara F, Jonghe PD, Sisodiya SM, Marini C. Diagnostic implications of genetic copy number variation in epilepsy plus. Epilepsia 2019; 60:689-706. [PMID: 30866059 PMCID: PMC6488157 DOI: 10.1111/epi.14683] [Citation(s) in RCA: 53] [Impact Index Per Article: 10.6] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 02/04/2019] [Accepted: 02/04/2019] [Indexed: 01/31/2023]
Abstract
OBJECTIVE Copy number variations (CNVs) represent a significant genetic risk for several neurodevelopmental disorders including epilepsy. As knowledge increases, reanalysis of existing data is essential. Reliable estimates of the contribution of CNVs to epilepsies from sizeable populations are not available. METHODS We assembled a cohort of 1255 patients with preexisting array comparative genomic hybridization or single nucleotide polymorphism array based CNV data. All patients had "epilepsy plus," defined as epilepsy with comorbid features, including intellectual disability, psychiatric symptoms, and other neurological and nonneurological features. CNV classification was conducted using a systematic filtering workflow adapted to epilepsy. RESULTS Of 1097 patients remaining after genetic data quality control, 120 individuals (10.9%) carried at least one autosomal CNV classified as pathogenic; 19 individuals (1.7%) carried at least one autosomal CNV classified as possibly pathogenic. Eleven patients (1%) carried more than one (possibly) pathogenic CNV. We identified CNVs covering recently reported (HNRNPU) or emerging (RORB) epilepsy genes, and further delineated the phenotype associated with mutations of these genes. Additional novel epilepsy candidate genes emerge from our study. Comparing phenotypic features of pathogenic CNV carriers to those of noncarriers of pathogenic CNVs, we show that patients with nonneurological comorbidities, especially dysmorphism, were more likely to carry pathogenic CNVs (odds ratio = 4.09, confidence interval = 2.51-6.68; P = 2.34 × 10-9 ). Meta-analysis including data from published control groups showed that the presence or absence of epilepsy did not affect the detected frequency of CNVs. SIGNIFICANCE The use of a specifically adapted workflow enabled identification of pathogenic autosomal CNVs in 10.9% of patients with epilepsy plus, which rose to 12.7% when we also considered possibly pathogenic CNVs. Our data indicate that epilepsy with comorbid features should be considered an indication for patients to be selected for a diagnostic algorithm including CNV detection. Collaborative large-scale CNV reanalysis leads to novel declaration of pathogenicity in unexplained cases and can promote discovery of promising candidate epilepsy genes.
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Affiliation(s)
- Antonietta Coppola
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyWC1N3BGUK
- The Chalfont Centre for EpilepsyChesham Lane, Chalfont St PeterBucksUK
- Epilepsy CentreDepartment of Neuroscience, Reproductive and Odontostomatological SciencesFederico II UniversityNaplesItaly
| | - Elena Cellini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and LaboratoriesNeuroscience DepartmentA Meyer Children‘s HospitalUniversity of FlorenceFlorenceItaly
| | - Hannah Stamberger
- Neurogenetics GroupCenter for Molecular NeurologyVIB2650AntwerpBelgium
- Laboratory of NeurogeneticsInstitute Born‐BungeUniversity of AntwerpAntwerpBelgium
- Department of NeurologyAntwerp University HospitalAntwerpBelgium
| | - Elmo Saarentaus
- Analytic and Translational Genetics UnitMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Stanley Center for Psychiatric ResearchBroad Institute of MIT and HarvardCambridgeMassachusettsUSA
- Institute of Molecular Medicine Finland FIMMUniversity of HelsinkiHelsinkiFinland
| | - Valentina Cetica
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and LaboratoriesNeuroscience DepartmentA Meyer Children‘s HospitalUniversity of FlorenceFlorenceItaly
| | - Dennis Lal
- Analytic and Translational Genetics UnitMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Stanley Center for Psychiatric ResearchBroad Institute of MIT and HarvardCambridgeMassachusettsUSA
- Epilepsy CenterNeurological InstituteCleveland ClinicClevelandOH44195US
- Genomic Medicine InstituteLerner Research Institute Cleveland ClinicClevelandOH44195US
- Cologne Center for GenomicsUniversity of CologneGermany
| | - Tania Djémié
- Neurogenetics GroupCenter for Molecular NeurologyVIB2650AntwerpBelgium
- Laboratory of NeurogeneticsInstitute Born‐BungeUniversity of AntwerpAntwerpBelgium
| | | | - Berten Ceulemans
- Department of Neurology‐Pediatric NeurologyUniversity and University Hospital AntwerpAntwerpBelgium
| | - J. Helen Cross
- Neurology DepartmentGreat Ormond Street HospitalNHS Foundation TrustLondonUK
- Clinical NeuroscienceUCL GOSH Institute of Child HealthLondonUK
- Young EpilepsyLingfieldUK
| | - Tine Deconinck
- Neurogenetics GroupCenter for Molecular NeurologyVIB2650AntwerpBelgium
- Laboratory of NeurogeneticsInstitute Born‐BungeUniversity of AntwerpAntwerpBelgium
| | | | - Thomas Dorn
- Swiss Epilepsy CenterBleulerstrasse 60CH‐8008Switzerland
| | - Renzo Guerrini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and LaboratoriesNeuroscience DepartmentA Meyer Children‘s HospitalUniversity of FlorenceFlorenceItaly
| | | | - Frank Kooy
- Department of Medical GeneticsUniversity of AntwerpAntwerpBelgium
| | - Lieven Lagae
- Department of Development and RegenerationSection Pediatric NeurologyUniversity Hospital KU Leuven3000LeuvenBelgium
| | - Nicholas Lench
- North East Thames Regional Genetics ServiceGreat Ormond Street Hospital for ChildrenNHS Foundation TrustLondonUK
| | - Johannes R. Lemke
- Institute of Human GeneticsUniversity of Leipzig Hospitals and ClinicsLeipzigGermany
| | - Ersilia Lucenteforte
- Department of Clinical and Experimental MedicineUniversity of Pisa, ItalyClinical Trial OfficeMeyer Children‘s HospitalFlorenceItaly
| | - Francesca Madia
- Neurogenetic LaboratoryScientific Institute for Research, Hospitalisation and Health Care (IRCCS) G. Gaslini InstituteGenovaItaly
| | - Heather C. Mefford
- Department of PediatricsDivision of Genetic MedicineUniversity of WashingtonSeattleUSA
| | - Deborah Morrogh
- North East Thames Regional Genetics ServiceGreat Ormond Street Hospital for ChildrenNHS Foundation TrustLondonUK
| | | | - Aarno Palotie
- Analytic and Translational Genetics UnitMassachusetts General HospitalHarvard Medical SchoolBostonMassachusettsUSA
- Stanley Center for Psychiatric ResearchBroad Institute of MIT and HarvardCambridgeMassachusettsUSA
- Institute of Molecular Medicine Finland FIMMUniversity of HelsinkiHelsinkiFinland
| | - An‐Sofie Schoonjans
- Department of Neurology‐Pediatric NeurologyUniversity and University Hospital AntwerpAntwerpBelgium
| | - Pasquale Striano
- Pediatric Neurology and Muscular Diseases UnitDINOGMI‐Department of Neurosciences, Rehabilitation, Ophthalmology Genetics, Maternal and Child HealthUniversity of Genoa, ‘G. Gaslini’ InstituteGenovaItaly
| | - Elzbieta Szczepanik
- Clinic of Neurology of Children and AdolescentsInstitute of Mother and ChildWarsawPoland
| | - Anna Tostevin
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyWC1N3BGUK
- The Chalfont Centre for EpilepsyChesham Lane, Chalfont St PeterBucksUK
| | - Joris R. Vermeesch
- Center for Human GeneticsUniversity Hospitals LeuvenHerestraat 493000LeuvenBelgium
| | - Hilde Van Esch
- Center for Human GeneticsUniversity Hospitals LeuvenHerestraat 493000LeuvenBelgium
| | - Wim Van Paesschen
- Department of NeurologyUniversity Hospitals LeuvenHerestraat 493000LeuvenBelgium
| | - Jonathan J Waters
- North East Thames Regional Genetics ServiceGreat Ormond Street Hospital for ChildrenNHS Foundation TrustLondonUK
| | - Sarah Weckhuysen
- Neurogenetics GroupCenter for Molecular NeurologyVIB2650AntwerpBelgium
- Laboratory of NeurogeneticsInstitute Born‐BungeUniversity of AntwerpAntwerpBelgium
- Department of NeurologyAntwerp University HospitalAntwerpBelgium
| | - Federico Zara
- Neurogenetic LaboratoryScientific Institute for Research, Hospitalisation and Health Care (IRCCS) G. Gaslini InstituteGenovaItaly
| | - Peter De Jonghe
- Neurogenetics GroupCenter for Molecular NeurologyVIB2650AntwerpBelgium
- Laboratory of NeurogeneticsInstitute Born‐BungeUniversity of AntwerpAntwerpBelgium
- Department of NeurologyAntwerp University HospitalAntwerpBelgium
| | - Sanjay M. Sisodiya
- Department of Clinical and Experimental EpilepsyUCL Queen Square Institute of NeurologyWC1N3BGUK
- The Chalfont Centre for EpilepsyChesham Lane, Chalfont St PeterBucksUK
| | - Carla Marini
- Pediatric Neurology, Neurogenetics and Neurobiology Unit and LaboratoriesNeuroscience DepartmentA Meyer Children‘s HospitalUniversity of FlorenceFlorenceItaly
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12
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Two Japanese cases of epileptic encephalopathy associated with an FGF12 mutation. Brain Dev 2018; 40:728-732. [PMID: 29699863 DOI: 10.1016/j.braindev.2018.04.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/22/2018] [Revised: 03/23/2018] [Accepted: 04/06/2018] [Indexed: 12/30/2022]
Abstract
A heterozygous mutation in the fibroblast growth factor 12 (FGF12) gene, which elevates the voltage dependence of neuronal sodium channel fast inactivation, was recently identified in some patients with epileptic encephalopathy. Here we report 1 Japanese patient diagnosed with early infantile epileptic encephalopathy (EIEE) and another diagnosed with epilepsy of infancy with migrating focal seizures (EIMFS). These 2 patients had an identical heterozygous missense mutation [c.341G>A:p.(Arg114His)] in FGF12 , which was identified with whole-exome sequencing. This mutation is identical to previously reported mutations in cases with early onset epileptic encephalopathy. One of our cases exhibited EIMFS, and this case responded to phenytoin and high-dose phenobarbital (PB). FGF12-related epileptic encephalopathy may exhibit diverse phenotypes and may respond to sodium channel blockers or high-dose PB.
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13
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Minassian BA. Understanding the brain one amino acid at a time - The case of the FHF1 R52H encephalopathy. Eur J Paediatr Neurol 2017; 21:699-700. [PMID: 28784232 DOI: 10.1016/j.ejpn.2017.07.013] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Affiliation(s)
- Berge A Minassian
- Division of Neurology, Department of Pediatrics, University of Texas Southwestern, USA; Program in Genetics and Genome Biology, The Hospital for Sick Children and University of Toronto, Canada.
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