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Paprocka J, Kaminiów K, Yetkin O, Tekturk P, Baykan B, Leiz S, Kluger G, Striano P. Clinical and epilepsy characteristics in Wolf-Hirschhorn syndrome (4p-): A review. Seizure 2024; 116:14-23. [PMID: 36526544 DOI: 10.1016/j.seizure.2022.12.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2022] [Revised: 11/23/2022] [Accepted: 12/07/2022] [Indexed: 12/13/2022] Open
Abstract
Wolf-Hirschhorn syndrome (WHS) is araredisorderwithan estimated prevalence being around 1 in 50,000 births. The syndrome is caused by the deletion of a critical region (Wolf-Hirschhorn Syndrome Critical region- WHSCR) on chromosome 4p16.3. WHS is clinically characterized by pre-and postnatal growth restriction, hypotonia, intellectual disability, craniofacial dysmorphismand congenital fusion anomalies. The clinical aspects are variable due to the deletion size.Consistently, epilepsy is one of the major concerns for parents and professionals caring for children with WHS. Seizures tend to occur in over 90% of patients, with onset within the first 3 years of life, and a peak incidence at around 6-12 months of age. Approximately 20% of patients had the first seizure onset within the first 6 months of age, almost 50% at 6 to 12 months of age and about 25% later than 12 months of age. The main types of epileptic seizures occurring in patients with WHS were generalized tonic-clonic seizures (around 70%). These were followed by tonic spasms (20%); focal seizures with impaired awareness (12%) and clonicseizures in 7% of patients.Seizures are often triggered by fever, followed by infections of various systems. Particularly, half of WHS patients experience status epilepticus in the first years of life, which can be fatal. Due to limited number of reports on the topic of EEG abnormalities in epilepsy among WHS patients, it is difficult to determine whether there are any characteristic deviations for WHS. Although more than 300 persons with WHS have been reported in the literature, there is sparse knowledge about epilepsy and methods of its anti-seizure medication (ASM) management with an assessment of their effectiveness. The purpose of this systematic review is to briefly summarize achievements and advances in the field of epilepsy in Wolf-Hirschhorn syndrome.
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Affiliation(s)
- Justyna Paprocka
- Pediatric Neurology Department, Faculty of Medical Sciences, Medical University of Silesia, Katowice, Poland.
| | - Konrad Kaminiów
- Students' Scientific Society, Pediatric Neurology Department, Faculty of Medical Sciences in Katowice, Medical University of Silesia, Katowice, Poland
| | - Ozgun Yetkin
- Department of Developmental Neurology, Poznań University of Medical Sciences, Poznań, Poland
| | - Pınar Tekturk
- Child Neurology and Neurology Departments, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Türkiy
| | - Betül Baykan
- Clinical Neurophysiology and Neurology Departments, Istanbul Faculty of Medicine, Istanbul University, Istanbul, Turkey
| | - Steffen Leiz
- Neuropädiatrie, KinderklinikDritter Orden, München, Germany
| | - Gerhard Kluger
- Institute for Transition, Rehabilitation and Palliation, Paracelsus Medical University, Salzburg, Austria; Center for Pediatric Neurology, Neurorehabilitation and Epileptology, Schoen KlinikVogtareuth, Vogtareuth, Germany
| | - Pasquale Striano
- IRCCS IstitutoGianninaGaslini", Genova, Italy; Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genova, Genova, Italy
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Status Epilepticus in Chromosomal Disorders Associated with Epilepsy: A Systematic Review. Genes (Basel) 2023; 14:genes14020299. [PMID: 36833226 PMCID: PMC9956098 DOI: 10.3390/genes14020299] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/29/2022] [Revised: 01/17/2023] [Accepted: 01/19/2023] [Indexed: 01/24/2023] Open
Abstract
Status Epilepticus (SE) is a neurological emergency resulting from the failure of mechanisms of seizure termination or from the initiation of mechanisms that lead to prolonged seizures. The International League Against Epilepsy (ILAE) identified 13 chromosomal disorders associated with epilepsy (CDAE); data regarding SE occurrence in these patients is lacking. A systematic scoping review was conducted to outline current literature evidence about clinical features, treatments, and outcomes of SE in pediatric and adult patients with CDAE. A total of 373 studies were identified with the initial search; 65 of these were selected and regarded as SE in Angelman Syndrome (AS, n = 20), Ring 20 Syndrome (R20, n = 24), and other syndromes (n = 21). Non-convulsive status epilepticus (NCSE) is frequently observed in AS and R20. No specific, targeted therapies for SE in CDAE are available to date; anecdotal reports about SE treatment are described in the text, as well as various brief- and long-term outcomes. Further evidence is needed to precisely portray the clinical features, treatment options, and outcomes of SE in these patients.
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Lee IC, Hong SY. Treatment of intractable seizure in Wolf-Hirschhorn syndrome with bromide. Brain Dev 2017; 39:633. [PMID: 28377151 DOI: 10.1016/j.braindev.2017.03.022] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/07/2017] [Revised: 03/14/2017] [Accepted: 03/15/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Inn-Chi Lee
- Department of Pediatrics, Chung Shan Medical University Hospital and Institute of Medicine, School of Medicine, Chung Shan Medical University, Taichung, Taiwan
| | - Syuan-Yu Hong
- Division of Pediatrics Neurology, Children's Hospital of China Medical University, 2 Yuh-Der Road, Taichung 404, Taiwan.
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Ho KS, Wassman ER. A case for cannabidiol in Wolf-Hirschhorn syndrome seizure management. Am J Med Genet A 2016; 173:324-326. [PMID: 28102593 PMCID: PMC6585685 DOI: 10.1002/ajmg.a.37979] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/08/2016] [Accepted: 08/29/2016] [Indexed: 12/14/2022]
Abstract
Complex, and sometimes intractable, seizures affect the quality of life and cognitive development of over 90% of individuals with Wolf-Hirschhorn syndrome (WHS). Fine resolution genotype-phenotype mapping of the WHS locus recently identified a candidate gene whose probable function has led to insights into a mechanism connecting WHS seizures with those of Dravet syndrome, a distinct condition caused by mutations in SCN1A and SCN1B. In addition to this possible molecular mechanistic connection, these disorders' seizures share a strikingly similar constellation of features, including clinical presentation, seizure types, early age of onset, EEG pattern, and responses to specific anti-epileptic drugs. Based in part on these similarities, we suggest that a highly successful Phase III clinical trial of a formulation of cannabidiol for Dravet syndrome seizures may be directly translatable into possible benefits for WHS individuals with challenging seizure patterns. © 2016 Wiley Periodicals, Inc.
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Affiliation(s)
- Karen S Ho
- Lineagen, Inc., Salt Lake City, Utah.,Department of Pediatrics, School of Medicine, University of Utah, Salt Lake City, Utah
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