CHD2-related epilepsy: novel mutations and new phenotypes

Dev Med Child Neurol. 2020 May;62(5):647-653. doi: 10.1111/dmcn.14367. Epub 2019 Nov 1.

Abstract

The aim of this report was to refine the genotypes and phenotypes of chromodomain helicase DNA-binding protein 2 (CHD2)-related epilepsy. Seventeen patients with CHD2 mutations were enrolled. CHD2 mutations were identified by application of next-generation sequencing of epilepsy or whole exome sequencing. Sixteen mutations were identified, among which 15 have not yet been reported. Thirteen mutations were de novo. Age at seizure onset ranged from 3 months to 10 years 5 months. Seizures observed were generalized tonic-clonic, myoclonic, atonic, atypical absence, focal, and myoclonic-atonic. Epileptic spasms occurred in two patients. Developmental disability was present in 14 patients. Autism features were observed in seven patients. Video electroencephalogram was abnormal in 15 patients. Five patients were diagnosed with non-specific epileptic encephalopathy, two with epilepsy with myoclonic-atonic seizures, two with Lennox-Gastaut syndrome, two with febrile seizures plus, and one with West syndrome. Seizures were controlled in nine patients. Q1392TfsX17 may be a hot-spot mutation of CHD2. West syndrome was observed as a new phenotype of CHD2 mutation. The severity of the phenotypes of CHD2 mutations ranged from mild febrile seizures to severe epileptic encephalopathy. WHAT THIS PAPER ADDS: Q1392TfsX17 maybe the hot-spot mutation of CHD2. West syndrome could be a new phenotype of CHD2 mutation.

CHD2基因突变相关癫痫的新突变和新表型: 本文研究的目的是总结CHD2基因突变相关癫痫的基因型和表型特点。采用靶向捕获二代测序癫痫基因检测包或全外显子组测序的方法发现17例患儿携带CHD2基因突变,共包括16种突变,其中15种为新突变,13种为新生突变。癫痫发作起病年龄为生后3个月-10岁5个月。病程中出现的发作类型包括全面强直阵挛发作、肌阵挛发作、失张力发作、不典型失神、局灶性发作和肌阵挛-失张力发作。2例患儿出现痉挛发作。14例患儿有不同程度的运动、智力发育落后,7例有孤独症样表现。15例患儿脑电图异常。癫痫综合征诊断符合非特异性早发癫痫性脑病5例,癫痫伴肌阵挛-失张力发作2例,Lennox-Gastaut综合征2例,热性惊厥附加症2例,婴儿痉挛症1例。9例患儿发作控制。 Q1392TfsX17 可能是CHD2基因的热点突变。婴儿痉挛症是CHD2基因突变相关癫痫的新表型。CHD2基因突变相关癫痫既可见于较轻的热性惊厥,也可以见于严重的癫痫性脑病。.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Brain / physiopathology
  • Child
  • Child, Preschool
  • DNA-Binding Proteins / genetics*
  • Developmental Disabilities / complications
  • Developmental Disabilities / genetics
  • Epilepsy / complications
  • Epilepsy / genetics*
  • Epilepsy / physiopathology
  • Female
  • Genotype
  • Humans
  • Infant
  • Male
  • Mutation
  • Pedigree
  • Phenotype
  • Spasms, Infantile / complications
  • Spasms, Infantile / genetics

Substances

  • CHD2 protein, human
  • DNA-Binding Proteins