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Clinical and Genetic Characterization of Inherited NPRL3 Splice Variants in Two Patients With Epilepsy
Shouxing Wang1, Jihua Wu1, Conglei Song1
1Department of Neurology, Anhui Provincial Children's Hospital/Children's Hospital of Fudan University (Affiliated Anhui Branch), Hefei, China.
NPRL3-related epilepsy (NRE) shows genetic and clinical variability, with incomplete penetrance. Tailored treatments are crucial for managing familial and sporadic epilepsy caused by NPRL3 variants.
Area of Science:
- Genetics
- Neurology
- Epilepsy Research
Background:
- NPRL3-related epilepsy (NRE) is a GATORopathy presenting with focal seizures.
- Genotype-phenotype correlations in NRE are not well understood.
- NPRL3 variants are linked to familial focal epilepsy and sleep-related hypermotor epilepsy.
Purpose of the Study:
- Investigate clinical and genetic features of NRE in two Chinese families.
- Analyze the genotype-phenotype spectrum of NRE through a literature review.
Main Methods:
- Whole-exome sequencing (WES) identified NPRL3 variants in two pediatric patients.
- Clinical, neuroimaging, laboratory, and genetic data were analyzed.
- A comprehensive literature review of 41 articles was performed.
Main Results:
- Identified inherited NPRL3 splice variants in two Chinese pediatric patients.
- Patients presented with focal seizures; neuroimaging was normal.
- Literature review revealed 94 NPRL3 variants in 84 pedigrees and 23 cohort cases, with 76% penetrance; loss-of-function variants predominated.
Conclusions:
- NRE exhibits genetic and clinical heterogeneity, incomplete penetrance, and phenotypic variability.
- Tailored antiepileptic management is essential.
- NPRL3 variants should be considered in familial and sporadic epilepsy cases.
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