De novo gain-of-function variants in KCNT2 as a novel cause of developmental and epileptic encephalopathy

Ann Neurol. 2018 Jun;83(6):1198-1204. doi: 10.1002/ana.25248.

Abstract

Variants in several potassium channel genes have been found in developmental and epileptic encephalopathies (DEE). We report on 2 females with de novo variants in KCNT2 with West syndrome followed by Lennox-Gastaut syndrome or with DEE with migrating focal seizures. After in vitro analysis suggested quinidine-responsive gain-of-function effects, we treated 1 of the girls with quinidine add-on therapy and achieved marked clinical improvements. This suggests that the new spectrum of KCNT2-related disorders do not only share similar phenotypic and in vitro functional and pharmacological features with previously known KCNT1-related disorders, but also represents a further example for possible precision medicine approaches. Ann Neurol 2018;83:1198-1204.

Publication types

  • Case Reports
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Child
  • Female
  • Green Fluorescent Proteins / genetics
  • Green Fluorescent Proteins / metabolism
  • HEK293 Cells
  • Humans
  • Infant, Newborn
  • Membrane Potentials / genetics
  • Models, Molecular
  • Mutation / genetics*
  • Neurodevelopmental Disorders / complications
  • Neurodevelopmental Disorders / genetics*
  • Patch-Clamp Techniques
  • Potassium Channels / genetics*
  • Potassium Channels / metabolism
  • Potassium Channels, Sodium-Activated
  • Spasms, Infantile / complications
  • Spasms, Infantile / genetics*
  • Transfection

Substances

  • KCNT2 protein, human
  • Potassium Channels
  • Potassium Channels, Sodium-Activated
  • Green Fluorescent Proteins