Rapid whole-genome sequencing identifies a novel GABRA1 variant associated with West syndrome
Lauge Farnaes1, Shareef A Nahas1, Shimul Chowdhury1
1Rady Children's Institute of Genomic Medicine (RCIGM), San Diego, California 92123, USA.
Insights
A novel genetic variant in the GABRA1 gene was identified in an infant with West syndrome. This finding links GABRA1 mutations to a specific form of this rare epilepsy disorder.
Area of Science:
- Neurogenetics
- Epileptology
- Developmental Pediatrics
Background:
- West syndrome is a severe infant epilepsy characterized by infantile spasms, hypsarrhythmia, and developmental delay.
- Genetic factors play a crucial role in the etiology of West syndrome, but causative genes remain unidentified in many cases.
Observation:
- A 9-month-old infant presented with infantile spasms, developmental delay, and esotropia, diagnosed with West syndrome.
- Standard neuroimaging (MRI) was normal, but EEG showed hypsarrhythmia.
- The infant showed improvement with topiramate and steroid treatment.
Findings:
- Whole-genome sequencing identified a novel, de novo variant (c.789G>A, p.Met263Ile) in the GABRA1 gene, which encodes the alpha-1 subunit of the GABA-A receptor.
- GABRA1 mutations are known to cause early infantile epileptic encephalopathy type 19 (EIEE19).
Implications:
- This study suggests that the identified GABRA1 variant (p.Met263Ile) is associated with a distinct phenotype of West syndrome.
- Understanding the genetic basis of West syndrome, particularly novel variants like this GABRA1 mutation, is crucial for accurate diagnosis and potential targeted therapies.
Abstract:
A 9-mo-old infant was admitted with infantile spasms that improved on administration of topiramate and steroids. He also had developmental delay, esotropia, and hypsarrhythmia on interictal electroencephalogram (EEG), and normal brain magnetic resonance imaging (MRI). West syndrome is the triad of infantile spasms, interictal hypsarrhythmia, and mental retardation. Rapid trio whole-genome sequencing (WGS) revealed a novel, likely pathogenic, de novo variant in the gene encoding γ-aminobutyric acid (GABA) type A receptor, α1 polypeptide (GABRA1 c.789G>A, p.Met263Ile) in the proband. GABRA1 mutations have been associated with early infantile epileptic encephalopathy type 19 (EIEE19). We suggest that GABRA1 p.Met263Ile is associated with a distinct West syndrome phenotype.
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