Primidone improves symptoms in TRPM3-linked developmental and epileptic encephalopathy with spike-and-wave activation in sleep.


Journal

Epilepsia
ISSN: 1528-1167
Titre abrégé: Epilepsia
Pays: United States
ID NLM: 2983306R

Informations de publication

Date de publication:
05 2023
Historique:
revised: 13 03 2023
received: 01 06 2022
accepted: 14 03 2023
medline: 11 5 2023
pubmed: 18 3 2023
entrez: 17 3 2023
Statut: ppublish

Résumé

Developmental and epileptic encephalopathy with continuous spike-and-wave activation in sleep (CSWS) or DEE-SWAS is an age-dependent disease, often accompanied by a decline in cognitive abilities. Early successful treatment of CSWS is associated with a better cognitive outcome. We retrospectively analyzed the clinical, electrophysiological, radiological, and genetic data of children with DEE-SWAS associated with melastatin-related transient receptor type 3 gene (TRPM3) missense variants. We report two unrelated children with pharmacoresistant DEE-SWAS and developmental delay/regression and different heterozygous de novo missense variants in the TRPM3 gene (NM_001366145.2; c.3397 T > C/p.Ser1133Pro, c.2004G > A/p.Val1002Met). The variant p.Val1002Met (previously known as p.Val990Met or p.Val837Met) and p.Ser1133Pro were recently shown to result in a gain-of-function effect. Based on this finding, previous drug resistance, and the experimentally demonstrated inhibitory effect of primidone on TRPM3, we initiated an individualized therapy with this drug. In both children, developmental regression was stopped, psychomotor development improved, and CSWS was no longer detectable. To our knowledge, this is the first report of a treatment with primidone in TRPM3-associated CSWS. Our results highlight the importance of early genetic diagnosis in patients with epilepsy and the possibility of precision medicine, which should be considered in the future in individuals with a TRPM3-linked DEE-SWAS.

Identifiants

pubmed: 36929095
doi: 10.1111/epi.17586
doi:

Substances chimiques

Primidone 13AFD7670Q
TRPM3 protein, human 0
Anticonvulsants 0

Types de publication

Journal Article Research Support, Non-U.S. Gov't

Langues

eng

Sous-ensembles de citation

IM

Pagination

e61-e68

Informations de copyright

© 2023 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.

Références

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Auteurs

Lena-Luise Becker (LL)

Department of Pediatric Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Center for Chronically Sick Children, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Institute for Cell Biology and Neurobiology, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Denise Horn (D)

Institute of Medical Genetics and Human Genetics, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Felix Boschann (F)

Institute of Medical Genetics and Human Genetics, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Evelien Van Hoeymissen (E)

Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine, University of Leuven, Leuven, Belgium.
VIB Center for Brain and Disease Research, Leuven, Belgium.
Laboratory of Endometrium, Endometriosis, and Reproductive Medicine, Department of Development and Regeneration, University of Leuven, Leuven, Belgium.

Thomas Voets (T)

Laboratory of Ion Channel Research, Department of Cellular and Molecular Medicine, University of Leuven, Leuven, Belgium.
VIB Center for Brain and Disease Research, Leuven, Belgium.

Joris Vriens (J)

Laboratory of Endometrium, Endometriosis, and Reproductive Medicine, Department of Development and Regeneration, University of Leuven, Leuven, Belgium.

Christine Prager (C)

Department of Pediatric Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Center for Chronically Sick Children, Charité-Universitätsmedizin Berlin, Berlin, Germany.

Angela M Kaindl (AM)

Department of Pediatric Neurology, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Center for Chronically Sick Children, Charité-Universitätsmedizin Berlin, Berlin, Germany.
Institute for Cell Biology and Neurobiology, Charité-Universitätsmedizin Berlin, Berlin, Germany.

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