临床儿科杂志 ›› 2021, Vol. 39 ›› Issue (3): 196-.doi: 10.3969/j.issn.1000-3606.2021.03.008

• 综合报道 • 上一篇    下一篇

KCNT1 基因变异相关婴儿癫痫伴游走性局灶性发作3 例报告

刘康, 孙素真, 庞领玉, 陈芳, 吴文娟   

  1. 河北省儿童医院神经内科(河北石家庄 050031)
  • 出版日期:2021-03-15 发布日期:2021-03-12
  • 通讯作者: 孙素真 电子信箱:13731121123 @ 163 .com
  • 基金资助:
    河北省医学科学研究重点课题计划(No. 20200629)

KCNT1 gene mutation associated epilepsy in infancy with migrating focal seizure in 3 cases

LIU Kang, SUN Suzhen, PANG Lingyu, CHEN Fang, WU Wenjuan   

  1. Department of Neurology, The Children’s Hospital of Hebei Province, Shijiazhuang 050031 , Hebei, China
  • Published:2021-03-15 Online:2021-03-12

摘要: 目 的 探 讨 KCNT 1 基因变异相关婴儿癫痫伴游走性局灶性发作( EIMFS )的临床特征及基 因变异特点 。方 法 回顾分析 3 例 KCNT 1 基因变异相关 EIMFS 患儿的临床资料 ,并复习相关文献 。结 果 2 例女性患儿分别于 3、6 月龄起病,1 例男性患儿于 2 月龄起病。3 例均以抽搐起病,经基因检测证实 为 KCNT 1 基因新发错义变异,分别为 c. 862 G>A(p.Gly 288 Ser)、c. 2813 A>G(p.Tyr 938 Cys)及 c. 1283 G>A (p.Arg 428 Gln)。1 例患儿头颅磁共振示髓鞘化延迟,胼胝体膝部薄 ;2 例视频脑电图示局灶性癫痫持续状态,其 中 1 例伴高度失律。3 例均予多种抗癫痫药物治疗,2 例予激素治疗,发作仍不能有效控制,并出现运动发育落后。 结论 KCNT 1可能是EIMFS主要致病基因,导致癫痫起病年龄早, 常合并发育迟缓,多种抗癫痫药物及激素治疗效果欠 佳,预后差。

关键词: KCNT 1基因; 婴儿癫痫伴游走性局灶性发作; 药物难治性癫痫

Abstract: Objective To explore the clinical and gene mutation characteristics of KCNT1 gene mutation associated epilepsy in infancy with migrating focal seizure. Methods The clinical data of KCNT 1 gene mutation associated epilepsy in infancy with migrating focal seizure in 3 children were retrospectively analyzed, and the related literature was reviewed. Results In 2 girls the age at onset was 3 months and at 6 months respectively. In 1 boy the age at onset was 2 months. All the 3 cases were onset with convulsions and diagnosed as new missense mutations of KCNT 1 gene by genetic test, which were respectively c. 862 G>A(p.Gly 288 Ser), c. 2813 A>G (p.Tyr 938 Cys), and c. 1283 G>A(p.Arg 428 Gln). The head magnetic resonance imaging of 2 cases was normal, while 1 case showed delayed myelination and thin knee of corpus callosum. VideoEEG showed focal status epilepticus in 2 cases, of which 1 case had hypsarrhythmia. All the 3 cases were treated with various antiepileptic drugs, but seizures failed to be effectively controlled, and cases appeared motor retardation and even regression. Conclusion KCNT 1 may be the main pathogenic gene of EIMFS,and leads to early onset of epilepsy often accompanied by developmental retardation, poor response to multi-antiepileptic drugs and poor prognosis.

Key words: KCNT 1 gene; epilepsy in infancy with migrating focal seizures; drug refractory epilepsy