Children with rare diseases: do they really have an increased risk of developing epilepsy?
© Pantaleoni et al. 2015
Published: 30 September 2015
Symptoms involving the central nervous system (CNS) are frequently part of the variable clinical picture of genetic-dysmorphic syndromes.
Seizure risk has been pointed out to be significantly higher in those with chromosomal abnormalities with respect to general population [4–6], and represent an important element to recognize and define for both diagnostic and therapeutic purposes.
Seizures' semeiology, severity and frequency can be highly variable in different syndromes, depending on the type of genetic defect, but even amongst subjects with the same genotype there can be a great variability in clinical manifestations, even intrafamiliarly.
Therefore, within the association between genetic syndromes and epilepsy, we should consider two possible situations:
Syndromes in which epilepsy could represent a “specific marker”. In certain conditions the recognition of a peculiar electroclinical phenotype could give a significant contribution to diagnostic definition of the syndrome. The best known example is Angelman syndrome [7, 8], in which the electroencephalographic (EEG) pattern could suggest the suspected diagnosis even in infants and toddlers, i.e. before the “classical” clinical and behavioral phenotype becomes evident. But epilepsy can represent a significant clinical marker in other conditions as well, such as Rett syndrome , Wolf-Hirschhorn syndrome , and other recently defined deletion or duplication syndromes.
Syndromes in which epilepsy is reported occasionally. In these conditions the diagnostic value of the electroclinical phenotype is limited, but the correct identification and treatment of the symptom still has an important effect on individual and familial health and quality of life.
Finally in genetic syndromes some special considerations should be made regarding the role of interictal EEG abnormalities and discussing clinical indications of antiepileptic treatment.
- Schinzel A, Niedrist D: Chromosome imbalances associated with epilepsy. Am J Med Genet. 2001, 106 (2): 119-124. 10.1002/ajmg.1576.PubMedView ArticleGoogle Scholar
- Bahi-Buisson N, Ville D, Eisermann M, Plouin P, Kaminska A, Chiron C: Epilepsy in chromosome aberrations. Arch Pediatr. 2005, 12 (4): 449-458. 10.1016/j.arcped.2004.12.016.PubMedView ArticleGoogle Scholar
- Battaglia A, Guerrini R: Chromosomal disorders associated with epilepsy. Epileptic Disord. 2005, 7 (3): 181-192.PubMedGoogle Scholar
- Kumada T, Ito M, Miyajima T, Fujii T, Okuno T, Go T, et al: Multi-institutional study on the correlation between chromosomal abnormalities and epilepsy. Brain Dev. 2005, 27 (2): 127-134. 10.1016/j.braindev.2003.12.010.PubMedView ArticleGoogle Scholar
- Parmeggiani A, Posar A, Giovannini S, Giovanardi-Rossi P: Epilepsy in chromosomal abnormalities: An Italian sample. J Child Neurol. 2005, 20 (5): 419-423. 10.1177/08830738050200050501.PubMedView ArticleGoogle Scholar
- Alfei E, Raviglione F, Franceschetti S, D'Arrigo S, Milani D, Selicorni A, et al: Seizures and EEG features in 74 patients with genetic-dysmorphic syndromes. Am J Med Genet A. 2014, 164 (12): 3154-61. 10.1002/ajmg.a.36746.View ArticleGoogle Scholar
- Boyd SG, Harden A, Patton MA: The EEG in early diagnosis of the Angelman (happy puppet) syndrome. Eur J Pediatr. 1988, 147 (5): 508-513. 10.1007/BF00441976.PubMedView ArticleGoogle Scholar
- Laan LA, Renier WO, Arts WF, Buntinx IM, Burgt IJ, Stroink VDH, et al: Evolution of epilepsy and EEG findings in Angelman syndrome. Epilepsia. 1997, 38 (2): 195-199. 10.1111/j.1528-1157.1997.tb01097.x.PubMedView ArticleGoogle Scholar
- Nissenkorn A, Gak E, Vecsler M, Reznik H, Menascu S, Ben Zeev B: Epilepsy in Rett syndrome-The experience of a National Rett Center. Epilepsia. 2010, 51 (7): 1252-1258.PubMedView ArticleGoogle Scholar
- Battaglia A, Filippi T, South ST, Carey JC: Spectrum of epilepsy and electroencephalogram patterns in Wolf-Hirschhorn syndrome: Experience with 87 patients. Dev Med Child Neurol. 2009, 51 (5): 373-380. 10.1111/j.1469-8749.2008.03233.x.PubMedView ArticleGoogle Scholar
This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.