Abstract:Objective: To investigate the characteristics of SCN1A,CDKL5 gene mutation in children with early epileptic encephalopathy and summarize its clinical characteristics. Methods: The clinical data of 40 children with early-onset epileptic encephalopathy treated in our hospital from April 2018 to April 2019 were selected, the peripheral blood of children and related family members were collected respectively. The peripheral blood of children were analyzed by targeted second-generation sequencing technique. The peripheral blood of family members was examined by sanger sequencing and the multiple-connection-dependent probe amplification technique (Multi-Ieligation- dependen,probe amplification,MLPA) was used to screen large gene fragments in children negative for mutations in the SCN1A and CDKL5 genes. Results: Among the 40 children with EOEE, there were 12 males and 28 females. The onset time of the disease was 6 days to 18 months after birth (10.11 ±4.29 months).There were 23 cases of infant spasm, 10 cases of nonspecific EOEE disease, 4 cases of Dravet syndrome and 3 cases of Daejeon syndrome.A total of 32 (80.00%) SCNIA,CDKL5 gene mutations were found in 40 children, including 17 (42.50%) SCNIA gene mutations, 15 (37.50%) CDKL5 gene mutations, or, 17 (42.50%) missense mutations, 3 (7.50%) insertion mutations, 3 (7.50%) nonsense mutations, 3 (7.50%) shear site mutations and 6 (15.00%) microdeletion mutations.Of the 32 children with SCNIA,CDKL5 gene mutation, 27 (84.38%) had no febrile convulsion for the first time, 6 (18.75%) had tonic clonus, 3 (9.38%) had systemic spasm, and 5 (15.63%) had spasm with the development of the disease.Of the 32 children with SCNIA,CDKL5 gene mutation, no significant language and independent walking ability were found. 21 cases (65.63%) had significantly lower sitting time than those of normal children of the same age, 28 cases (87.50%) had symptoms of autism, and 11 cases (34.38%) had low hand and foot function and slow body development.Conclusion: SCN1A, CDKL5 gene mutation related to EOEE disease in children with early onset, and the clinical manifestations are various, which will seriously affect the growth and development of children. Therefore, it is necessary to explore more targeted treatments on the basis of early antiepileptic drugs and dietetic therapy.
廖赵妹, 蔡思铭, 陈剑标, 吕华龙, 雷智贤. 早发性癫痫脑病患儿SCN1A CDKL5基因突变特点与临床特征[J]. 河北医学, 2022, 28(6): 950-954.
LIAO Zhaomei, CAI Siming, CHEN Jianbiao, et al. Characteristics and Clinical Features of Mutations in the SCN1A and CDKL5 Genes in Children with Early-Onset Epilepsy Encephalopathy. HeBei Med, 2022, 28(6): 950-954.
[1] Lauren,Elizabeth,Walker,et al.Molecular isoforms of high-mobility group box 1 are mechanistic biomarkers for epilepsy.[J].Clin Invest,2019,129(5):2166. [2] 孙莹,段丽芬,王惠萍,等.不明原因智力障碍共患癫痫患儿的临床特征及相关致病基因分析[J].河北医学,2020,26(12):2032-2036. [3] 钟忆,束晓梅.CDKL5基因新生变异致早发性癫痫脑病1例报告[J].临床儿科杂志,2020,38(11):814-816. [4] 陈晨,尹飞,李波,等.33例儿童癫痫伴枕区痫样放电的临床特点分析[J].中国医师杂志,2019,21(9):1287-1291. [5] 梅红芳,张澜,王瑾,等.ARV1基因变异致婴儿早发性癫痫性脑病一例并文献复习[J].中国小儿急救医学,2022,29(3):224-228. [6] Xu W, Zhang W, Cui L,et al.Novel mutation of SIK1 gene causing a mild form of pediatric epilepsy in a Chinese patient[J].Metab Brain Dis,2022,37(4):1207-1219. [7] Welzel L, Schidlitzki A, Twele F,et al.A face-to-face comparison of the intra-amygdala and intrahippocampal kainate mouse models of mesial temporal lobe epilepsy and their utility for testing novel therapies[J].Epilepsia,2020,61(1):157-170. [8] 康庆云,廖红梅,杨赛,等.离子通道基因突变相关儿童癫痫性脑病33例临床特征和基因突变分析[J].神经损伤与功能重建,2021,16(12):774-776. [9] 曾琦,张月华.良性癫痫与癫痫性脑病共享致病基因研究进展[J].中华儿科杂志,2019,57(4):309-312. [10] 郭玮,郁莉斐,蒋丽军,等.基因变异所致早发癫性脑病患儿临床特点及相关基因表型的临床分析[J].中国医药,2021,16(7):1033-1037. [11] 王翠,贾天明,张晓莉,等.Dravet综合征患儿SCN1A基因突变特点与其临床表型的相关性及药物疗效[J].中华实用儿科临床杂志,2019,34(9):684-688. [12] 梅道启,陈国洪,王媛,等.CDKL5基因相关早发性癫痫性脑病临床特征及基因突变分析[J].中华神经科杂志,2021,54(4):320-328.