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Eur J Paediatr Neurol ; 15(5): 432-8, 2011 Sep.
Article in English | MEDLINE | ID: mdl-21775177

ABSTRACT

PURPOSES: To perform CDKL5 mutation screening in Thai children with cryptogenic infantile intractable epilepsy and to determine the clinical sensitivity of CDKL5 screening when different inclusion criteria were applied. METHODS: Children with cryptogenic infantile intractable epilepsy were screened for CDKL5 mutation using multiplex ligation-dependent probe amplification and DNA sequencing. The clinical sensitivity was reviewed by combining the results of studies using similar inclusion screening criteria. RESULTS: Thirty children (19 girls and 11 boys) with a median seizure onset of 7 months were screened. Almost a half had infantile spasms and one fifth had stereotypic hand movements. A novel c.2854C>T (p.R952X) was identified in an ambulatory girl who had severe mental retardation, multiple types of seizures without Rett-like features. Her mother had a mild intellectual disability, yet her grandmother and half sister were normal despite having the same genetic alteration (random X-inactivation patterns). The pathogenicity of p.R952X identified here was uncertain since healthy relatives and 6 female controls also harbor this alteration. The clinical sensitivity of CDKL5 mutation screening among females with Rett-like features and negative MECP2 screening was 7.8% while the clinical sensitivity among females having cryptogenic intractable seizures with an onset before the ages of 12, 6 and 3 months were 4.7, 11.6 and 14.3%, respectively.


Subject(s)
Genetic Predisposition to Disease/genetics , Mutation/genetics , Protein Serine-Threonine Kinases/genetics , Spasms, Infantile/diagnosis , Spasms, Infantile/genetics , Child , Child, Preschool , Female , Humans , Infant , Infant, Newborn , Intellectual Disability/genetics , Male , Pedigree , Prospective Studies , Spasms, Infantile/physiopathology , Thailand , X Chromosome Inactivation/genetics
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