Abstract:
OBJECTIVE:Mutations involving the cyclin-dependent kinase-like 5 (CDKL5) gene cause an early onset epileptic encephalopathy (EE) with severe neurologic impairment and a skewed 12:1 female-to-male ratio. To date, 18 mutations have been described in boys. We analyzed our cohort of boys with early onset EE to assess the diagnostic yield of our molecular approach. METHODS:We studied 74 boys who presented early onset severe seizures, including infantile spasms and developmental delay, in the setting of EE, using Sanger sequencing, next-generation sequencing (NGS) and multiplex ligation-dependent probe amplification (MLPA). RESULTS:We identified alterations involving CDKL5 in four boys (5.4%) using NGS in one and MLPA in three. Three of four mutations were indicative of somatic mosaicism. SIGNIFICANCE:CDKL5 gene mutations accounted for 5.4% of boys with early onset EE. Somatic mosaic mutations might be even more represented than germline mutations, probably because their less deleterious effect enhances viability of the male embryo. The molecular approach used for CDKL5 screening remarkably influences the diagnostic yield in boys. Diagnosis is optimized by Sanger sequencing combined with array-based methods or MLPA; alternatively, NGS targeted resequencing designed to also detect copy number alterations, may be performed.
journal_name
Epilepsiajournal_title
Epilepsiaauthors
Mei D,Darra F,Barba C,Marini C,Fontana E,Chiti L,Parrini E,Dalla Bernardina B,Guerrini Rdoi
10.1111/epi.12803subject
Has Abstractpub_date
2014-11-01 00:00:00pages
1748-53issue
11eissn
0013-9580issn
1528-1167journal_volume
55pub_type
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