Clinical and molecular characterization of Unverricht-Lundborg disease among Egyptian patients

Epilepsy Res. 2021 Oct:176:106746. doi: 10.1016/j.eplepsyres.2021.106746. Epub 2021 Aug 25.


Background and purpose: Unverricht-Lundborg disease (ULD) is a common type of progressive myoclonic epilepsy (PME). It is caused mostly by biallelic dodecamer repeat expansions in the promoter region of CSTB gene. Despite highly prevalent in the Mediterranean countries, no studies have been reported from Egypt. This article study the presence of CSTB gene mutations among Egyptian patients clinically suspected with ULD, and describes the clinical and genetic characteristics of those with confirmed gene mutation.

Methods: Medical records of patients following up in two specialized epilepsy clinics in Cairo, Egypt were retrospectively reviewed. Twenty patients who belonged to 13 unrelated families were provisionally diagnosed with ULD based on the clinical presentation. Genetic testing was done. Clinical characteristics, demographic data and EEG findings were documented.

Results: Genetic studies confirmed the presence of the CSTB dodecamer repeat expansion in 14 patients from 8 families (frequency 70 %). The mean duration of the follow-up was 5 years. Male to female distribution was 1:1 with a mean age of onset 9.7 years. Consanguinity was noted in 4 families. Eight patients had their first seizure between the age of 10 and 20 years. Myoclonic jerks ranged in severity from mild in three unrelated patients to severe in one. Only 3 had cognitive impairment.

Conclusion: Our study confirms the presence of CSTB mutation among Egyptian patients suspected with ULD. There was no clear phenotype-genotype correlation among the studied group of patients. In addition, we noticed variable inter and intra familial severity among patients from the same family.

Keywords: CSTB; EPM1; Egyptian patients; Myoclonic epilepsy; Unverricht-Lundborg.

MeSH terms

  • Cystatin B / genetics
  • Egypt / epidemiology
  • Female
  • Humans
  • Male
  • Myoclonic Epilepsies, Progressive*
  • Retrospective Studies
  • Unverricht-Lundborg Syndrome* / genetics


  • Cystatin B