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CHD2基因相关癫痫的临床特点和遗传学分析

  • 张晓莉 ,
  • 王梦月 ,
  • 张晨宇 ,
  • 李佳霖 ,
  • 马轶超 ,
  • 王俊玲 ,
  • 李小丽 ,
  • 韩瑞 ,
  • 徐丹 ,
  • 贾天明
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  • 郑州大学第三附属医院儿内科(河南郑州 450052)

收稿日期: 2022-12-06

  网络出版日期: 2024-02-02

Clinical Features And Genetic Characteristics Of Epilepsy Associated With CHD2 Gene Variants

  • Xiaoli ZHANG ,
  • Mengyue WANG ,
  • Chenyu ZHANG ,
  • Jialin LI ,
  • Yichao MA ,
  • Junling WANG ,
  • Xiaoli LI ,
  • Rui HAN ,
  • Dan XU ,
  • Tianming JIA
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  • Department of Pediatrics, The Third Affiliated Hospital of Zhengzhou University, Zhengzhou 450052, Henan, China

Received date: 2022-12-06

  Online published: 2024-02-02

摘要

目的 研究CHD2基因变异相关癫痫患者的临床表型及基因型特点。方法 对6例CHD2基因变异相关癫痫患者的临床表现、脑电图、基因特点及抗癫痫发作药物疗效等进行回顾性总结分析。结果 6例患儿中男5例、女1例,癫痫起病年龄为1岁8个月至12岁。癫痫发作类型包括局灶性发作及全面性强直阵挛发作各3例次,眼睑肌阵挛伴或不伴失神发作2例次,不典型失神发作、痉挛发作、肌阵挛发作及强直发作各1例次。3例诊断为癫痫综合征,其中2例为Jeavons综合征,1例为Lennox-Gastaut综合征;2例具有光敏性。共患病中智力障碍6例,注意力缺陷多动障碍3例,孤独症谱系疾病2例,精神障碍1例。6例CHD2基因变异中4例为新发突变,2例为母源;其中无义突变3例,错义突变2例,片段缺失1例。末次随访年龄5岁至15岁10月龄,5例患儿抗癫痫药物规律治疗,4例有效,其中2例癫痫发作控制超2年,1例控制1年8月。结论 癫痫发作是CHD2基因变异的常见表型,癫痫起病年龄差别较大,表型为Jeavons综合征者预后不良,丙戊酸钠对CHD2基因变异相关癫痫疗效相对较好。精神障碍为罕见临床表型。

本文引用格式

张晓莉 , 王梦月 , 张晨宇 , 李佳霖 , 马轶超 , 王俊玲 , 李小丽 , 韩瑞 , 徐丹 , 贾天明 . CHD2基因相关癫痫的临床特点和遗传学分析[J]. 临床儿科杂志, 2024 , 42(2) : 121 -126 . DOI: 10.12372/jcp.2024.22e1638

Abstract

Objective To analyze the clinical features and genetic characteristics of patients with epilepsy associated with CHD2 gene variants. Methods The clinical features, electroencephalogram (EEG), genotypes and responses to the anti-seizure medications (ASM) of 6 patients with CHD2 gene variants were retrospectively analyzed. Results The onset age of seizures in the 6 patients (5 males and 1 female) ranged from 20 months to 12 years. Multiple seizure types were observed, including focal seizures in 3 cases, generalized tonic-clonic seizures in 3 cases, eyelid myoclonus with or without absence seizures in 2 cases, atypical absence seizures in 1 case, epileptic spasms in 1 case, myoclonic seizures in 1 case and tonic seizures in 1 case. Three patients were diagnosed with epilepsy syndrome, of which 2 were Jeavons syndrome and 1 was Lennox-Gastaut syndrome. Two cases were photosensitive. All 6 patients had comorbidities, including 6 patients 6 were intellectual disability, 3 attention deficit hyperactivity disorder, 2 autism spectrum disorders, and 1 mental disorder. 4 patients carried de novo mutations and the other 2 were maternal origin in the CHD2 gene. Of these, 3 were nonsense variants, 2 were missense variants and 1 was 3.58-Mb deletion including CHD2. Within the follow-up of 5 years to 15 years, 4 of the 5 patients were effective with regular ASM. Two patients achieved seizure-free more than 2 years, 1 patients achieved seizure-free more than 1 year and 8 months. Conclusion Epileptic seizures are common clinical phenotype of patients with CHD2 gene variants. The common seizure types include focal and generalized tonic-clonic seizures, and the age of onset of epilepsy varies widely. Patients with Jeavons syndrome have poor prognosis. Valproate may show a positive effect on epilepsy with CHD2 gene variation. Mental disorder is a rare clinical phenotype.

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