Cited by 100Epilepsy research and treatmentGenetics and Neurodevelopmental DisordersPharmacological Effects and Toxicity Studies

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CHD2 myoclonic encephalopathy is frequently associated with self-induced seizures

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Abstract

OBJECTIVE: To delineate the phenotype of early childhood epileptic encephalopathy due to de novo mutations of CHD2, which encodes the chromodomain helicase DNA binding protein 2. METHODS: We analyzed the medical history, MRI, and video-EEG recordings of 9 individuals with de novo CHD2 mutations and one with a de novo 15q26 deletion encompassing CHD2. RESULTS: Seizures began at a mean of 26 months (12-42) with myoclonic seizures in all 10 cases. Seven exhibited exquisite clinical photosensitivity; 6 self-induced with the television. Absence seizures occurred in 9 patients including typical (4), atypical (2), and absence seizures with eyelid myoclonias (4). Generalized tonic-clonic seizures occurred in 9 of 10 cases with a mean onset of 5.8 years. Convulsive and nonconvulsive status epilepticus were later features (6/10, mean onset 9 years). Tonic (40%) and atonic (30%) seizures also occurred. In 3 cases, an unusual seizure type, the atonic-myoclonic-absence was captured on video. A phenotypic spectrum was identified with 7 cases having moderate to severe intellectual disability and refractory seizures including tonic attacks. Their mean age at onset was 23 months. Three cases had a later age at onset (34 months) with relative preservation of intellect and an initial response to antiepileptic medication. CONCLUSION: The phenotypic spectrum of CHD2 encephalopathy has distinctive features of myoclonic epilepsy, marked clinical photosensitivity, atonic-myoclonic-absence, and intellectual disability ranging from mild to severe. Recognition of this genetic entity will permit earlier diagnosis and enable the development of targeted therapies.

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Metadata

Authors
Thomas, R. H., Zhang, L. M., Carvill, G. L., Archer, J. S., Heavin, S. B., Mandelstam, S. A., Craiu, D., Berkovic, S. F., Gill, D. S., Mefford, H. C., Scheffer, I. E., Paalotie, A., Lehesjoki, A.-E., Koeleman, B., Marini, C., Depienne, C., Craiu, D., Pal, D., Hoffman-Zacharska, D., Leguern, E., Zara, F., Rosenow, F., Caglayan, H., Hjalgrim, H., Muhle, H., Lerche, H., Helbig, I., Jähn, J., Lemke, J., Serratosa, J. M., Selmer, K., Klein, K. M., Sterbova, K., Pendziwiat, M., Barisic, N., Gormley, P., Striano, P., May, P., De Jonghe, P., Guerrini, R., Møller, R., Krause, R., Balling, R., Sisodiya, S., von Spiczak, S., Weckhuysen, S., Baulac, S., Suls, A., Djemie, T., Talvik, T., Stephani, U., Komarek, V., & Weber, Y.
Affiliations
Royal Children's Hospital (AU)
Venue
Neurology
Published
2015-03-03
Volume
84
Issue
9
Pages
951-958
ISSN
  • 0028-3878 (ISSN-L)
  • 1526-632X
OpenAlex
W2081757946
Cited by
100
References
24
Citations by year
2026: 4 · 2025: 10 · 2024: 14 · 2023: 8 · 2022: 14 · 2021: 8 · 2020: 11 · 2019: 5 · 2018: 6 · 2017: 6 · 2016: 8 · 2015: 6
FWCI
7.03
Type
journal article
Language
en
Open access
Locations
  • Neurology (publishedVersion)
  • Europe PMC (PubMed Central) (publishedVersion)
  • PubMed Central (publishedVersion)
  • PubMed (publishedVersion)
  • ORCA Online Research @Cardiff (Cardiff University) (acceptedVersion)
  • Minerva Access (University of Melbourne) (submittedVersion)
  • Open Repository and Bibliography (University of Luxembourg) (submittedVersion)
Funders
National Institute of Neurological Disorders and Stroke (K99NS089858)
Topics
  • Health Sciences › Medicine › Clinical Neurology › Epilepsy research and treatment
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Genetics and Neurodevelopmental Disorders
  • Health Sciences › Medicine › Pediatrics, Perinatology and Child Health › Pharmacological Effects and Toxicity Studies
Keywords
CHD2, myoclonic encephalopathy, de novo mutations, self-induced seizures, absence seizures, status epilepticus, intellectual disability, phenotypic spectrum, refractory seizures, seizure onset age
MeSH terms
Adolescent, Adult, Child, DNA-Binding Proteins, Epilepsies, Myoclonic, Female, Humans, Male, Photic Stimulation, Seizures, Cohort Studies, Young Adult

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