Xp22.3 genomic deletions involving the CDKL5 gene in girls with early onset epileptic encephalopathy

Davide Mei, Carla Marini, Francesca Novara, Bernardo D. Bernardina, Tiziana Granata, Elena Fontana, Elena Parrini, Anna R. Ferrari, Alessandra Murgia, Orsetta Zuffardi, Renzo Guerrini

Research output: Contribution to journalArticle

Abstract

Purpose: Mutations of the X-linked gene cyclin-dependent kinase-like 5 (CDKL5) cause an X-linked encephalopathy with early onset intractable epilepsy, including infantile spasms and other seizure types, and a Rett syndrome (RTT)-like phenotype. Very limited information is available on the frequency and phenotypic spectrum associated with CDKL5 deletions/duplications. We investigated the role of CDKL5 deletions/duplications in causing early onset intractable epilepsy of unknown etiology in girls. Methods: We studied 49 girls with early onset intractable epilepsy, with or without infantile spasms, and developmental impairment, for whom no etiologic factors were obvious after clinical examination, brain magnetic resonance imaging (MRI) and expanded screening for inborn errors of metabolism. We performed CDKL5 gene mutation analysis in all and multiplex ligation dependent probe amplification assay (MLPA) in those who were mutation negative. Custom Array-comparative genomic hybridization (CGH), breakpoint polymerase chain reaction (PCR) analysis, and X-inactivation studies were performed in patients in whom MLPA uncovered a genomic alteration. Results: We found CDKL5 mutations in 8.2% (4 of 49) of patients and genomic deletions in 8.2% (4 of 49). Overall, abnormalities of the CDKL5 gene accounted for 16.3% (8 of 49) of patients. Discussion: CDKL5 gene deletions are an under-ascertained cause of early onset intractable epilepsy in girls. Genetic testing of CDKL5, including both mutation and deletion/duplication analysis, should be considered in this clinical subgroup.

Original languageEnglish
Pages (from-to)647-654
Number of pages8
JournalEpilepsia
Volume51
Issue number4
DOIs
Publication statusPublished - Apr 2010

Keywords

  • CDKL5
  • Early onset epileptic encephalopathy
  • Infantile spasms

ASJC Scopus subject areas

  • Clinical Neurology
  • Neurology

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