Refractory epilepsy and regression in a patient with a de novo heterozygous POGZ mutation

Seiya Yamagata, Ayako Hattori, Fuyuki Miya, Yuko Kubota, Takeshi Endo, Yutaka Negishi, Yuji Nakamura, Tatsuhiko Tsunoda, Kenjiro Kosaki, Shinji Saitoh

Research output: Contribution to journalArticle

Abstract

Mutations in the pogo transposable element with zinc finger domain(POGZ)gene are associated with autism spectrum disorder (ASD)and intellectual disability. A total of 40 cases have been reported, and their clinical features include severe phenotypes such as severe speech and language delay, vision problems, microcephaly, and a predisposition towards obesity. Although 20% of these cases showed EEG abnormalities, epilepsy has not been reported. We present the case of a patient with refractory epilepsy and regression in which whole exome sequencing identified a de novo heterozygous POGZ mutation(c.2102del;p.Pro701Leufs 18). He was diagnosed with autism spectrum disorder at 6 years of age. From 7 years and 8 months of age, he experienced epileptic seizures that involved falling backwards, head nodding and ocular deviation. An EEG showed a spike-and-slow-wave at F3 and F4. He was diagnosed with frontal lobe epilepsy, and treated with various anti-epileptic drugs (e.g. CZP, VPA, CLB, PHT, LTG, PB, CBZ and LEV), which eventually reduced his epileptic seizures from over 10 to 2-3 times per day. Moreover, this patient had repetitive aspiration pneumonia from 14 years of age, necessitating a tracheotomy and laryngo-tracheal separation. Phenotypes associated with a POGZ mutation might, therefore, have a wider spectrum than previously recognized, and include not only ASD, but various neurological problems such as progressive epilepsy syndrome.

Original languageEnglish
Pages (from-to)29-32
Number of pages4
JournalNO TO HATTATSU
Volume51
Issue number1
DOIs
Publication statusPublished - 2019

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health
  • Clinical Neurology

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