TY - JOUR
T1 - Electroclinical features of MEF2C haploinsufficiency-related epilepsy
T2 - A multicenter European study
AU - Raviglione, Federico
AU - Douzgou, Sofia
AU - Scala, Marcello
AU - Mingarelli, Alessia
AU - D'Arrigo, Stefano
AU - Freri, Elena
AU - Darra, Francesca
AU - Giglio, Sabrina
AU - Bonaglia, Maria C
AU - Pantaleoni, Chiara
AU - Mastrangelo, Massimo
AU - Epifanio, Roberta
AU - Elia, Maurizio
AU - Saletti, Veronica
AU - Morlino, Silvia
AU - Vari, Maria Stella
AU - De Liso, Paola
AU - Pavaine, Julija
AU - Spaccini, Luigina
AU - Cattaneo, Elisa
AU - Gardella, Elena
AU - Møller, Rikke S
AU - Marchese, Francesca
AU - Colonna, Clara
AU - Gandioli, Claudia
AU - Gobbi, Giuseppe
AU - Ram, Dipak
AU - Palumbo, Orazio
AU - Carella, Massimo
AU - Germano, Michele
AU - Tonduti, Davide
AU - De Angelis, Diego
AU - Caputo, Davide
AU - Bergonzini, Patrizia
AU - Novara, Francesca
AU - Zuffardi, Orsetta
AU - Verrotti, Alberto
AU - Orsini, Alessandro
AU - Bonuccelli, Alice
AU - De Muto, Maria Carmela
AU - Trivisano, Marina
AU - Vigevano, Federico
AU - Granata, Tiziana
AU - Bernardina, Bernardo Dalla
AU - Tranchina, Antonia
AU - Striano, Pasquale
N1 - Copyright © 2021. Published by Elsevier Ltd.
PY - 2021/5
Y1 - 2021/5
N2 - PURPOSE: Epilepsy is a main manifestation in the autosomal dominant mental retardation syndrome caused by heterozygous variants in MEF2C. We aimed to delineate the electro-clinical features and refine the genotype-phenotype correlations in patients with MEF2C haploinsufficiency.METHODS: We thoroughly investigated 25 patients with genetically confirmed MEF2C-syndrome across 12 different European Genetics and Epilepsy Centers, focusing on the epileptic phenotype. Clinical features (seizure types, onset, evolution, and response to therapy), EEG recordings during waking/sleep, and neuroimaging findings were analyzed. We also performed a detailed literature review using the terms "MEF2C", "seizures", and "epilepsy".RESULTS: Epilepsy was diagnosed in 19 out of 25 (~80%) subjects, with age at onset <30 months. Ten individuals (40%) presented with febrile seizures and myoclonic seizures occurred in ~50% of patients. Epileptiform abnormalities were observed in 20/25 patients (80%) and hypoplasia/partial agenesis of the corpus callosum was detected in 12/25 patients (~50%). Nine patients harbored a 5q14.3 deletion encompassing MEF2C and at least one other gene. In 7 out of 10 patients with myoclonic seizures, MIR9-2 and LINC00461 were also deleted, whereas ADGRV1 was involved in 3/4 patients with spasms.CONCLUSION: The epileptic phenotype of MEF2C-syndrome is variable. Febrile and myoclonic seizures are the most frequent, usually associated with a slowing of the background activity and irregular diffuse discharges of frontally dominant, symmetric or asymmetric, slow theta waves with interposed spike-and-waves complexes. The haploinsufficiency of ADGRV1, MIR9-2, and LINC00461 likely contributes to myoclonic seizures and spasms in patients with MEF2C syndrome.
AB - PURPOSE: Epilepsy is a main manifestation in the autosomal dominant mental retardation syndrome caused by heterozygous variants in MEF2C. We aimed to delineate the electro-clinical features and refine the genotype-phenotype correlations in patients with MEF2C haploinsufficiency.METHODS: We thoroughly investigated 25 patients with genetically confirmed MEF2C-syndrome across 12 different European Genetics and Epilepsy Centers, focusing on the epileptic phenotype. Clinical features (seizure types, onset, evolution, and response to therapy), EEG recordings during waking/sleep, and neuroimaging findings were analyzed. We also performed a detailed literature review using the terms "MEF2C", "seizures", and "epilepsy".RESULTS: Epilepsy was diagnosed in 19 out of 25 (~80%) subjects, with age at onset <30 months. Ten individuals (40%) presented with febrile seizures and myoclonic seizures occurred in ~50% of patients. Epileptiform abnormalities were observed in 20/25 patients (80%) and hypoplasia/partial agenesis of the corpus callosum was detected in 12/25 patients (~50%). Nine patients harbored a 5q14.3 deletion encompassing MEF2C and at least one other gene. In 7 out of 10 patients with myoclonic seizures, MIR9-2 and LINC00461 were also deleted, whereas ADGRV1 was involved in 3/4 patients with spasms.CONCLUSION: The epileptic phenotype of MEF2C-syndrome is variable. Febrile and myoclonic seizures are the most frequent, usually associated with a slowing of the background activity and irregular diffuse discharges of frontally dominant, symmetric or asymmetric, slow theta waves with interposed spike-and-waves complexes. The haploinsufficiency of ADGRV1, MIR9-2, and LINC00461 likely contributes to myoclonic seizures and spasms in patients with MEF2C syndrome.
U2 - 10.1016/j.seizure.2021.03.025
DO - 10.1016/j.seizure.2021.03.025
M3 - Article
C2 - 33831796
SN - 1059-1311
VL - 88
SP - 60
EP - 72
JO - Seizure : the journal of the British Epilepsy Association
JF - Seizure : the journal of the British Epilepsy Association
ER -