16p11.2微缺失相关儿童癫痫的临床表型与遗传学特征分析

Clinical phenotype and genetic features of 16p11.2 microdeletion-related epilepsy in children

摘要:

目的 探究16p11.2微缺失相关儿童癫痫的临床表型与遗传学特征。 方法 回顾性收集200例应用全外显子测序技术进行癫痫遗传学分析的癫痫患儿，其中9例癫痫患儿为16p11.2微缺失，分析9例16p11.2微缺失患儿的临床表型及遗传学特征。 结果 16p11.2微缺失检出率为4.5%（9/200）。9例患儿为3~10月龄的婴儿；癫痫发作形式为局灶运动性发作伴意识障碍，部分进展为全身强直-阵挛发作；发作间期脑电图为局灶或多灶性痫样放电，对抗癫痫药物反应良好。9例患儿16p11.2缺失片段大小在398~906 kb之间，缺失基因数为23~33个，且均为致病性变异，其中2例为母源性来源，1例为父源性来源，余均为新发变异。 结论 16p11.2微缺失在癫痫患儿中有一定的检出率，16p11.2微缺失多为新发变异，且为基因大片段缺失；16p11.2微缺失相关儿童癫痫多在出生1年内起病且为药物反应性癫痫。 引用格式：中国当代儿科杂志，2022，24（5）：585-590

Abstract:

Objective To study the clinical phenotype and genetic features of 16p11.2 microdeletion-related epilepsy in children. Methods The medical data of 200 children with epilepsy who underwent a genetic analysis of epilepsy by the whole exon sequencing technology were collected retrospectively, of whom 9 children with epilepsy had 16p11.2 microdeletion. The clinical phenotype and genetic features of the 9 children with 16p11.2 microdeletion were analyzed. Results The detection rate of 16p11.2 microdeletion was 4.5% (9/200). The 9 children with 16p11.2 microdeletion were 3-10 months old. They experienced focal motor seizures with consciousness disturbance, and some of the seizures developed into generalized tonic-clonic seizures. The interictal electroencephalogram showed focal or multifocal epileptiform discharge, and all 9 children responded well to antiepileptic drugs. The 9 children had a 16p11.2 deletion fragment size of 398-906 kb, and the number of deleted genes was 23-33 which were all pathogenic mutations. The mutation was of maternal origin in 2 children, of paternal origin in 1 child, and de novo in the other children. Conclusions 16p11.2 microdeletion can be detected in some children with epilepsy. Most of the 16p11.2 microdeletion is de novo mutation and large gene fragment deletion. The onset of 16p11.2 microdeletion-related epilepsy in children is mostly within 1 year of life, and the epilepsy is drug-responsive.