Stickler syndrome associated with epilepsy: report of three cases

Eur J Pediatr. 2015 May;174(5):697-701. doi: 10.1007/s00431-015-2514-8. Epub 2015 Mar 27.

Abstract

Stickler syndrome is a genetically heterogeneous collagenopathy characterized by auditory, ocular, musculoskeletal, and orofacial abnormalities. Stickler syndrome type 1 typically presents ophthalmologic involvement and is due to heterozygous defects of the COL2A1 gene, that have been also identified as the molecular cause of a continuous spectrum of different disorders mainly affecting the cartilage and bone (i.e., Kniest dysplasia, achondrogenesis type II, Legg-Calvè-Perthes disease). We report three Caucasian children with: (a) ocular, oral, facial, auditory, and musculoskeletal manifestations of Stickler syndrome type 1; (b) history of generalized and/or partial seizures coupled with abnormal electroencephalographic records; and (c) pathogenic heterozygous mutations of the COL2A1 gene. Epilepsy has been never reported so far in literature as a possible feature of Stickler syndrome, although neurological presentations, including epilepsy and brain abnormalities, have been occasionally described in other COL2A1-related phenotypes (e.g., Legg-Calvè-Perthes disease).

Conclusions: This report raises the possibility of a potential occurrence of seizures among the clinical manifestations of Stickler syndrome type 1, suggesting the presence of a continuous neurological spectrum in some individuals harboring heterozygous mutations in COL2A1.

What is known: • Stickler syndrome is a genetically heterogeneous collagenopathy characterized by auditory, ocular, musculoskeletal, and orofacial anomalies. What is New: • Involvement of the nervous central system is not a typical feature of Stickler syndrome and the association with epilepsy has not been reported so far. • This report raises the possibility of a potential occurrence of seizures among the clinical manifestations of Stickler syndrome type 1, suggesting a continuous neurological spectrum in some individuals affected by heterozygous mutations of COL2A1.

Publication types

  • Case Reports

MeSH terms

  • Arthritis / complications*
  • Arthritis / genetics
  • Collagen Type II / genetics
  • Connective Tissue Diseases / complications*
  • Connective Tissue Diseases / genetics
  • Epilepsy / etiology*
  • Female
  • Hearing Loss, Sensorineural / complications*
  • Hearing Loss, Sensorineural / genetics
  • Humans
  • Infant, Newborn
  • Male
  • Retinal Detachment / complications*
  • Retinal Detachment / genetics
  • Seizures / etiology

Substances

  • COL2A1 protein, human
  • Collagen Type II

Supplementary concepts

  • Stickler syndrome, type 1