Not all SCN1A epileptic encephalopathies are Dravet syndrome

Lynette G. Sadleir, Emily I. Mountier, Deepak Gill, Suzanne Davis, Charuta Joshi, Catherine Devile, Manju A. Kurian, Simone Mandelstam, Elaine Wirrell, Katherine C. Nickels, Hema R. Murali, Gemma Carvill, Candace T. Myers, Heather C. Mefford, Ingrid E. Scheffer

Research output: Contribution to journalArticle

30 Scopus citations

Abstract

To define a distinct SCN1A developmental and epileptic encephalopathy with early onset, profound impairment, and movement disorder. Methods: A case series of 9 children were identified with a profound developmental and epileptic encephalopathy and SCN1A mutation. Results: We identified 9 children 3 to 12 years of age; 7 were male. Seizure onset was at 6 to 12 weeks with hemiclonic seizures, bilateral tonic-clonic seizures, or spasms. All children had profound developmental impairment and were nonverbal and nonambulatory, and 7 of 9 required a gastrostomy. A hyperkinetic movement disorder occurred in all and was characterized by dystonia and choreoathetosis with prominent oral dyskinesia and onset from 2 to 20 months of age. Eight had a recurrent missense SCN1A mutation, p.Thr226Met. The remaining child had the missense mutation p.Pro1345Ser. The mutation arose de novo in 8 of 9; for the remaining case, the mother was negative and the father was unavailable. Conclusions: Here, we present a phenotype-genotype correlation for SCN1A. We describe a distinct SCN1A phenotype, early infantile SCN1A encephalopathy, which is readily distinguishable from the well-recognized entities of Dravet syndrome and genetic epilepsy with febrile seizures plus. This disorder has an earlier age at onset, profound developmental impairment, and a distinctive hyperkinetic movement disorder, setting it apart from Dravet syndrome. Remarkably, 8 of 9 children had the recurrent missense mutation p.Thr226Met.

Original languageEnglish (US)
Pages (from-to)1035-1042
Number of pages8
JournalNeurology
Volume89
Issue number10
DOIs
StatePublished - Sep 5 2017

ASJC Scopus subject areas

  • Clinical Neurology

Fingerprint Dive into the research topics of 'Not all SCN1A epileptic encephalopathies are Dravet syndrome'. Together they form a unique fingerprint.

  • Cite this

    Sadleir, L. G., Mountier, E. I., Gill, D., Davis, S., Joshi, C., Devile, C., Kurian, M. A., Mandelstam, S., Wirrell, E., Nickels, K. C., Murali, H. R., Carvill, G., Myers, C. T., Mefford, H. C., & Scheffer, I. E. (2017). Not all SCN1A epileptic encephalopathies are Dravet syndrome. Neurology, 89(10), 1035-1042. https://doi.org/10.1212/WNL.0000000000004331