Clinical features of childhood-onset paroxysmal kinesigenic dyskinesia with PRRT2 gene mutations

Dev Med Child Neurol. 2013 Apr;55(4):327-34. doi: 10.1111/dmcn.12056. Epub 2013 Jan 30.

Abstract

Aim: To define better the phenotype and genotype of familial and sporadic cases of paroxysmal kinesigenic dyskinesia (PKD) caused by mutations in the PRRT2 gene presenting in the paediatric age group.

Method: We report the detailed clinical and molecular genetic features of 11 patients (six females, five males) with childhood-onset PRRT2-mutation-positive PKD.

Results: Mean age at disease onset was 8 years 7.5 months (range 5-11y), and clinical presentation was characterized by daily short paroxysmal episodes of dystonia/dyskinesia. Most patients also had non-kinesigenic attacks in addition to the classical movement-induced paroxysmal episodes. One family demonstrated great phenotypic variability with PKD, infantile convulsions, and/or hemiplegic migraine affecting different family members with the same mutation. All patients in whom antiepileptics (carbamazepine/phenytoin) were tried showed a dramatic improvement with complete abolition of dyskinetic episodes.

Interpretation: Our case series provides a detailed clinical description of patients with PRRT2-PKD, and reports a spectrum of disease-causing mutations, thereby expanding both the clinical phenotype and mutation spectrum of disease.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adolescent
  • Adult
  • Age of Onset
  • Child
  • Child, Preschool
  • Codon, Nonsense
  • Cohort Studies
  • Dyskinesias / genetics*
  • Epilepsy, Benign Neonatal / genetics*
  • Female
  • Frameshift Mutation
  • Humans
  • Male
  • Membrane Proteins / genetics*
  • Middle Aged
  • Migraine with Aura / genetics
  • Movement Disorders / genetics*
  • Mutation*
  • Mutation, Missense
  • Nerve Tissue Proteins / genetics*
  • Phenotype
  • Seizures / genetics*
  • United Kingdom
  • Young Adult

Substances

  • Codon, Nonsense
  • Membrane Proteins
  • Nerve Tissue Proteins
  • PRRT2 protein, human

Supplementary concepts

  • Infantile convulsions and paroxysmal choreoathetosis, familial