实用医学杂志 ›› 2021, Vol. 37 ›› Issue (19): 2473-2476.doi: 10.3969/j.issn.1006⁃5725.2021.19.008

• 临床研究 • 上一篇    下一篇

PRRT2基因突变家系临床表型及治疗效果分析

孙萌, 王鑫, 周冉, 程亚颖   

  1. 河北省人民医院儿科(石家庄 050051)

  • 出版日期:2021-10-10 发布日期:2021-10-10
  • 基金资助:
    2019 年度河北省医学科学研究课题计划(编号:20190296)

Clinical phenotype and therapeutic effect of PRRT2 gene mutation families

SUN Meng,WANG Xin,ZHOU  Ran   

  1. CHENG Yaying. Department of Pediatrics,Hebei Provincial General People′s Hospital,Shijiazhuang 050051 China

  • Online:2021-10-10 Published:2021-10-10

摘要:

目的 总结 PRRT2 基因突变家系病例的临床表型,评估抗癫痫药疗效,为临床诊治提供依 据。方法 回顾性总结 2018 年 11 月至 2021 年 2 月我院收治的 PRRT2 基因突变 4 个家系受累成员的临床 表型,并对其治疗效果进行分析。结果 4 个家系受累成员 9 例,在婴儿期表现为良性家族性婴儿癫痫 (BFIE)而青少年期表现为发作性运动诱发性运动障碍(PKD)表型者 3 例;婴儿期 BFIE 表型者 5 例,其 中 3 例目前尚在幼儿期是否出现 PKD 表型尚不能确定;仅有 PKD 表型者 1 例为成年女性。8 例 BFIE 表型 者,其中 6 例未治疗均在 2 岁内发作停止;2 例首选左乙拉西坦未控制发作换用奥卡西平后症状缓解;4 例 PKD 表型者,其中 3 例低剂量奥卡西平即可控制发作。结论 PRRT2 基因突变家系中最常见的临床表型 为 BFIE 和 PKD,部分受累者婴儿期出现 BFIE 表型,青少年期可能出现 PKD 表型。较低剂量的奥卡西平治 疗有效,左乙拉西坦治疗效果差,甚至加重发作。

关键词:

 , PRRT2基因, 突变, 良性家族性婴儿癫痫, 发作性运动诱发性运动障碍, 奥卡西平

Abstract:

Objective To summarize the clinical phenotype characteristics of the PRRT2 gene mutation family and analyze the treatment effect in order to provide evidence for the clinical diagnosis and treatment. Methods Clinical data of PRRT2⁃positive patients and their family members who received treatment in our hospital from November 2018 to February 2021 were selected and the therapeutic effect was analyzed. Results A total of 3 patients showed benign familial infantile epilepsy(BFIE in infancy and paroxysmal kinesigenic dyskinesia (PKD)in adolescence. Four patients were diagnosed with BFIE in infancy,and among them,three are still in early childhood with uncertain PKD phenotype;one adult female patient was only diagnosed with PKD. Six patients with BFIE were not treated and improved within 2 years of age. The symptoms of the 2 patients could be relieved by low⁃dose of oxcarbazepine. The symptoms of the 3 patients with PKD could be relieved by low⁃dose of oxcarbaze⁃ pine. Conclusions The most common clinical phenotypes in families with PRRT2 gene mutations are BFIE and PKD. Some affected populations have BFIE phenotypes in infancy,and PKD phenotypes may appear in adoles⁃ cence. Lower dosage of oxcarbazepine is effective in treatment,while levetiracetam has poor therapeutic effects and may even worsen the attack.

Key words:

PRRT2 gene, mutation, BFIE, PKD, oxcarbazepine