1. Mild Lafora disease: clinical, neurophysiologic, and genetic findings
- Author
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Elena Pasini, Maurizio Viri, Rosa Guerrero-López, Marina Casazza, Silvana Franceschetti, Edoardo Ferlazzo, Antonio Gambardella, Patrizia Riguzzi, Rosaria Plasmati, Umberto Aguglia, Angelo Labate, Roberto Michelucci, Julie Turnbull, Lilia Volpi, Sara Gasparini, Flavio Villani, Elena Gennaro, Laura Canafoglia, José M. Serratosa, Berge A. Minassian, and Federico Zara
- Subjects
Adult ,Male ,medicine.medical_specialty ,Disease onset ,Adolescent ,Ubiquitin-Protein Ligases ,Progressive myoclonus epilepsy ,Mild ,Electroencephalography ,Audiology ,medicine.disease_cause ,Compound heterozygosity ,Gastroenterology ,Lafora disease ,Young Adult ,Internal medicine ,medicine ,Dementia ,Humans ,Non-Receptor ,In patient ,EEG ,Longitudinal Studies ,Mutation ,medicine.diagnostic_test ,Slowly progressive ,Carrier Proteins ,Female ,Italy ,Middle Aged ,Protein Tyrosine Phosphatases, Non-Receptor ,Lafora Disease ,medicine.disease ,Neurology ,Neurology (clinical) ,Protein Tyrosine Phosphatases ,Psychology - Abstract
We report clinical, neurophysiologic, and genetic features of an Italian series of patients with Lafora disease (LD) to identify distinguishing features of those with a slowly progressive course. Twenty-three patients with LD (17 female; 6 male) were recruited. Mean age (± SD) at the disease onset was 14.5 ± 3.9 years and mean follow-up duration was 13.2 ± 8.0 years. NHLRC1 mutations were detected in 18 patients; EPM2A mutations were identified in 5. Patients who maintained >10 years gait autonomy were labeled as "mild" and were compared with the remaining LD patients with a typical course. Six of 23 patients were mild and presented significantly delay in the age at onset, lower neurologic disability score at 4 years after the onset, less severe seizure phenotype, lower probability of showing both photoparoxysmal response on electroencephalography (EEG) and giant somatosensory evoked potentials, as compared to patients with typical LD. However, in both mild and typical LD patients, EEG showed disorganization of background activity and frequent epileptiform abnormalities. Mild LD patients had NHLRC1 mutations and five of six carried homozygous or compound heterozygous D146N mutation. This mutation was found in none of the patients with typical LD. The occurrence of specific NHLRC1 mutations in patients with mild LD should be taken into account in clinical practice for appropriate management and counseling.
- Published
- 2014