与肌性性发作:遗传病因,结果和预后指标
Simona Pellacani1,2, Simona Balestrini1,2,3, Edoardo Fino1,2
1Neuroscience and Human Genetics Department, Meyer Children's Hospital IRCCS, Florence 50139, Italy.
肌性发作 (杜斯综合征) 的是一种复杂的儿童. 遗传因素和早期神经发育评估是理解结果和指导治疗的关键.
科学领域:
- 儿科神经学 儿科神经学
- 临床遗传学 临床遗传学
- 发病学 (Epileptology) 是一个专业的学科.
背景情况:
- 肌性发作性 (以前称为杜斯综合征) 是一种罕见的儿童的亚型.
- 了解其遗传基础,临床过程和预后因素对于患者管理至关重要.
研究的目的:
- 调查一大群患有肌性发作的患者的遗传决定因素,长期结果和预后指标.
- 为了确定发作结果,智力障碍和并发症的预测因素.
主要方法:
- 对60名被诊断为患有肌性-动脉性发作的患者进行了回顾性分析.
- 综合数据收集包括临床,EEG,神经成像,神经心理和遗传数据 (下一代测序).
- 使用适当的测试进行统计分析,以确定结果的预测因素.
主要成果:
- 肌痛性性发作是主要的发作类型 (91.7%).
- 瓦尔酸盐,埃索苏西米德,二类药物和巴比他都有效;较新的药物没有显示任何益处.
- 在61.7%的患者中获得了无性发作,其中38.3%的患者经历了耐药性.
- 智力障碍影响了58.3%,ADHD是最常见的并发症 (40%).
- 全球发育迟缓预测药物耐药性和智力障碍.
- 在38.5%的被测序患者中发现了致病变体,包括该综合征的新型基因.
结论:
- 肌痛性发作是一种异质综合征,具有多种遗传原因和可变的结果.
- 早期神经发育评估是一个重要的预后指标.
- 整个外体序列应该优先考虑早期诊断和遗传咨询.
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