Recurrent generalized seizures, visual loss, and palinopsia as phenotypic features of neuronal ceroid lipofuscinosis due to progranulin gene mutation

Epilepsia. 2014 Jun;55(6):e56-9. doi: 10.1111/epi.12632. Epub 2014 Apr 29.

Abstract

We detail the phenotype of a novel form of neuronal ceroid lipofuscinosis due to a homozygous progranulin gene mutation (c.813_816del; CLN11 MIM #614706). The symptoms appeared in two young adult siblings, and included progressive retinopathy, recurrent generalized seizures, moderate ataxia, and subtle cognitive dysfunction. Long-lasting episodes of palinopsia were a recurring symptom and associated with polyphasic visual-evoked potential waveform that suggested hyperexcitability of the occipital cortex. Electroencephalography showed rare spike-wave paroxysms, and magnetic resonance imaging revealed selective cerebellar atrophy. Skin biopsy revealed fingerprint storage and the absence of progranulin protein. Electron microscopy of peripheral blood leukocytes showed fingerprint profiles in 1/100 lymphocytes. These findings define a novel phenotype and provide clues for better understanding of progranulin function. A PowerPoint slide summarizing this article is available for download in the Supporting Information section here.

Keywords: Frontotemporal dementia; Kufs' disease; Palinopsia; Progranulin; Recessive ataxia.

Publication types

  • Case Reports

MeSH terms

  • Atrophy
  • Brain / pathology
  • Brain / physiopathology
  • Cerebellum / pathology
  • Electroencephalography
  • Evoked Potentials, Visual
  • Humans
  • Intercellular Signaling Peptides and Proteins / genetics*
  • Magnetic Resonance Imaging
  • Male
  • Mutation
  • Neuroimaging
  • Neuronal Ceroid-Lipofuscinoses / genetics*
  • Neuronal Ceroid-Lipofuscinoses / physiopathology
  • Phenotype
  • Progranulins
  • Recurrence
  • Retinal Diseases / genetics*
  • Seizures / genetics*
  • Siblings
  • Young Adult

Substances

  • GRN protein, human
  • Intercellular Signaling Peptides and Proteins
  • Progranulins