临床儿科杂志 ›› 2018, Vol. 36 ›› Issue (9): 662-.doi: 10.3969/j.issn.1000-3606.2018.09.004

• 围产新生儿疾病专栏 • 上一篇    下一篇

KCNQ2 突变导致的新生儿期早发癫痫性脑病临床分析#br#

王珏 1, 刘勇乐 2, 朱慧 2, 林新富 1   

  1. 福建医科大学省立临床学院 福建省立医院1.儿科,2.新生儿科(福建福州 350001)
  • 收稿日期:2018-09-15 出版日期:2018-09-15 发布日期:2018-09-15
  • 通讯作者: 林新富 E-mail:418665840@qq.com
  • 基金资助:
    福建省卫生系统中青年骨干人才培养项目资助计划(No.2015-ZQN-ZD-7);福建省自然科学基金项目(No.2016J01501)

Clinical analysis of neonatal-onset epileptic encephalopathy caused by KCNQ2 mutation

 WANG Jue1, LIU Yongle2, ZHU Hui2, LIN Xinfu1   

  1. 1. Department of Pediatrics, 2. Newborn Pediatrics, Provincial Clinic College of Fujian Medical University, Fujian Provincial Hospital, Fuzhou 350001, Fujian, China
  • Received:2018-09-15 Online:2018-09-15 Published:2018-09-15

摘要: 目的 探讨KCNQ2基因突变导致的新生儿期癫痫性脑病的临床特点。方法 回顾分析9例新生儿期起病的 KCNQ2癫痫性脑病患儿的临床资料。结果 9例患儿中男5例、女4例,起病中位年龄2天(0.5小时~8天),确诊时中位年 龄10个月(1个月~5岁)。 患儿以强直或不对称强直发作常见;脑电图以爆发抑制模式多见;均为KCNQ2新生杂合突变。 诊断为大田原综合征5例,非综合征的癫痫性脑病4例。予多种药物治疗后, 6例患儿癫痫发作缓解。患儿均有明显的运动 及智力发育落后。结论 KCNQ2突变导致的癫痫性脑病主要在出生后1周以内起病,预后不良,基因检测可明确诊断。

Abstract:  Objective To explore the clinical characteristics of neonatal-onset epileptic encephalopathy caused by KCNQ2 gene mutation. Method The clinical data of 9 cases of neonatal-onset epileptic encephalopathy caused by KCNQ2 mutation were retrospective analyzed. Results In 9 children (5 boys and 4 girls), median onset age was 2 days (0.5 hours to 8 days) and the median age was 10 months (1 month to 5 years) at the time of diagnosis. A total of nine heterozygous de novo KCNQ2 missense mutations were identified. They had common features such as tonic seizures or asymmetrical tonic seizures and a suppression-burst EEG pattern. Five cases were diagnosed of Ohtahara syndrome and four cases were diagnosed of unknown syndrome epileptic encephalopathy. After treatment with multiple drugs, 6 cases were seizure free. All of them had obvious motor and mental retardation. Conclusion Epileptic encephalopathy caused by KCNQ2 mutation mainly occurs within one week after birth, and the prognosis is poor. Gene detection can confirm the diagnose.