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Childhood-Onset Refractory Absence Epilepsy as a Presentation of Glucose Transporter 1 Deficiency Syndrome Type 2: A
Hana Ahmed1, Mohammad Alsumaili1, Muhammad Saeed1
1Department of Pediatrics, Armed forces hospital, southern region, Khamis Mushit, Saudia Arabia.
Insights
Glucose transporter 1 (GLUT1) deficiency syndrome, a rare metabolic disorder, causes drug-resistant epilepsy. Early diagnosis via genetic testing and ketogenic diet treatment significantly improve outcomes for affected children.
Area of Science:
- Neuroscience
- Genetics
- Metabolic Disorders
Background:
- Glucose transporter 1 (GLUT1) deficiency syndrome is a rare genetic disorder affecting glucose transport across the blood-brain barrier.
- Classic symptoms include early-onset, drug-resistant epilepsy (particularly absence seizures), cognitive delays, and movement disorders.
Purpose of the Study:
- To highlight the importance of genetic evaluation in cases of refractory absence epilepsy.
- To present a case demonstrating the efficacy of the ketogenic diet in treating GLUT1 deficiency syndrome.
Main Methods:
- Whole exome sequencing was performed to identify the genetic cause of epilepsy.
- The patient was treated with a ketogenic diet.
Main Results:
- A heterozygous mutation in the SLC2A1 gene confirmed a diagnosis of autosomal dominant GLUT1 deficiency syndrome type 2.
- The patient experienced significant clinical improvement after initiating the ketogenic diet.
Conclusions:
- Refractory absence epilepsy warrants genetic investigation for potential underlying conditions like GLUT1 deficiency.
- The ketogenic diet is a crucial therapeutic intervention for managing GLUT1 deficiency syndrome.
Abstract:
Glucose transporter 1 (GLUT1) deficiency syndrome is a rare metabolic disorder caused by mutations in the SLC2A1 gene resulting in impaired glucose transport through the blood-brain barrier. The "classic" phenotype in children includes early-onset drug-resistant epilepsy, especially absence epilepsy, cognitive delay, movement disorders, and microcephaly. The ketogenic diet is the only treatment. We report a case of a 12-year-old girl who presented at the age of 11 years with daily absence seizures unresponsive to multiple antiseizure medications. Her poor therapeutic response raised suspicion for an underlying genetic etiology. Whole exome sequencing revealed a heterozygous mutation in the SLC2A1 gene, confirming a diagnosis of autosomal dominant GLUT1 deficiency syndrome type 2. The patient showed significant clinical improvement following the initiation of the ketogenic diet. This case highlights the importance of genetic evaluation in refractory absence epilepsy and the role of dietary therapy in GLUT1 deficiency.
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