Type 1 early infantile epileptic encephalopathy: A case report and literature review

Mol Genet Genomic Med. 2024 Feb;12(2):e2412. doi: 10.1002/mgg3.2412.

Abstract

Background: Variants in the Aristaless-related homeobox (ARX) gene lead to a variety of phenotypes, with intellectual disability being a steady feature. Other features can include severe epilepsy, spasticity, movement disorders, hydranencephaly, and ambiguous genitalia in males. X-linked Ohtahara syndrome or Type 1 early infantile epileptic encephalopathy (EIEE1) is a severe early-onset epileptic encephalopathy with arrested psychomotor development caused by hemizygous mutations in the ARX gene, which encodes a transcription factor in fundamental brain developmental processes.

Methods: We presented a case report of a 2-year-old boy who exhibited symptoms such as microcephaly, seizures, and severe multifocal epileptic abnormalities, and genetic techniques such as autozygosity mapping, Sanger sequencing, and whole-exome sequencing.

Results: We confirmed that the patient had the NM_139058.3:c.84C>A; p.(Cys28Ter) mutation in the ARX gene.

Conclusion: The patient with EIEE1 had physical symptoms and hypsarrhythmia on electroencephalogram. Genetic testing identified a causative mutation in the ARX gene, emphasizing the role of genetic testing in EIEE diagnosis.

Keywords: ARX; Aristaless-related homeobox; EIEE1; Ohtahara syndrome; early infantile epileptic encephalopathy.

Publication types

  • Review
  • Case Reports

MeSH terms

  • Child, Preschool
  • Epilepsy* / genetics
  • Homeodomain Proteins / genetics
  • Humans
  • Male
  • Spasms, Infantile* / diagnosis
  • Spasms, Infantile* / genetics
  • Transcription Factors / genetics

Substances

  • Homeodomain Proteins
  • Transcription Factors

Supplementary concepts

  • Infantile Epileptic-Dyskinetic Encephalopathy