Successful Treatment of Schwartz-Jampel Syndrome with Botulinum Toxin Type A

Schwartz-Jampel syndrome (SJS) is a rare autosomal recessive disorder characterized by typical facial dysmorphism, generalized muscle stiffness, joint contracture, and skeletal abnormalities. This condition is caused by mutations in the heparan sulfate proteoglycan 2 (HSPG2) gene, which encodes perlecan, a component of the basement membrane. The management of patients with SJS primarily aims to alleviate symptoms related to muscle stiffness. In this report, we describe a male patient with SJS type 1A. Trio whole-exome sequencing identified a pathogenic mutation (NM_001291860.1: c.10897C>T; p.Arg3633Ter) and variants of unknown significance (NM_001291860.2: c.413+10G>T). The patient experienced difficulty in opening his eyes and mouth, which significantly limited his daily activities. Botulinum toxin A injection was administered and demonstrated significant clinical improvement after the treatment.

Mutational and phenotypic expansion of ATP1A3-related disorders: Report of nine cases

BACKGROUND

Mutations in the ATP1A3 gene are known to be the cause of three distinct neurological syndromes including alternating hemiplegia of childhood (AHC), rapid-onset dystonia parkinsonism (RDP) and cerebellar ataxia, arefexia, pes cavus, optic atrophy and sensorineural hearing impairment (CAPOS). Recent studies have suggested the broader diversity of ATP1A3-related disorders. This study aimed to investigate the clinical spectrum in patients carrying causative mutations within the ATP1A3 gene.

METHOD

The medical histories of nine unrelated patients with diverse phenotypes harboring variants in ATP1A3 were retrospectively analyzed after they were referred to a tertiary epilepsy center in one of the two different health care systems (Germany or Thailand). Clinical features, neurophysiological data, imaging results, genetic characteristics and treatments were reviewed.

RESULTS

Three patients harbor novel mutations in the ATP1A3 gene. Atypical clinical features and imaging findings were observed in two cases, one with hemiplegia-hemiconvulsion-epilepsy syndrome, and the other with neurodegeneration with brain iron accumulation. All nine patients presented with intellectual impairment. Alternating hemiplegia of childhood (AHC) was the most common phenotype (67%). Flunarizine and topiramate led to symptom reduction in 83% and 25% of AHC cases administered, respectively.

CONCLUSION

The present case series expands the clinical and genetic spectrum of ATP1A3-related disorders.

Rare epileptic syndrome of ring chromosome 20 with epileptic encephalopathy: a case report

The authors report the clinical features, electroencephalography (EEG), neuroimaging (brain magnetic resonance image-MRI), and cytogenetic findings of a young female patient with rare cytogenetic anomalies characterized by de novo 46, XX, r (20) (p13q13.3). The patient had a history of mild mental retardation, emotional liability and intractable epilepsy with non-convulsive status epilepticus. The MRI brain showed focal cerebral dysplasia over the left temporal region. The multiple seizures were refractory to antiepileptic medications and prolonged, confused state with or without a motor component. The continuous video-EEG monitor showed epileptiform discharges over bilateral frontal regions with frontal origin. The symptoms were relieved after midazolam infusion. A patient who was present with intractable epilepsy with continuous frontal epileptiform discharges, mental retardation, abnormal behavior, without dysmorphic features should be suspected of chromosomal abnormalities especially ring chromosome 20.

Quality of life in adolescent absence epilepsy at Queen Sirikit National Institute of Child Health

OBJECTIVE

To compare the QoL between adolescents with absence epilepsy and the other types of epilepsies.

MATERIAL AND METHOD

A prospective cohort study was conducted in adolescents aged 10-18 years that have been diagnosed with epilepsy at QSNICH between 2000 and 2012. The QoL was assessed using the QoLIE-AD-48, Thai version.

RESULTS

Seventy-three adolescents were included in this study, of which 27 had absence epilepsy. The mean total QoLIE-AD-48 score was 63.94 (17.14). The absence group had a mean score of 74.45 (9.83), while the non-absence group had a score of 57.78 (17.57), p-value < 0.001.

CONCLUSION

The QoL of adolescents with inactive absence epilepsy was significantly higher than those suffering with other types of epilepsy. The QoL in this study was similar to prior studies.