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Northern Epilepsy

CLN8 Northern Epilepsy Variant


Presentation

  • These cutaneous markers for TSC may be present at birth, but most commonly develop during childhood. Ungual fibromas are present in 20%-90% of individuals with TSC (Figure 5).[clinicaladvisor.com]
  • Typically, it presents in children aged 3–5 years and can persist into adulthood.[en.wikipedia.org]
  • Patients tend to present with symptoms after the age of 50 and then progression can be very variable depending on the individual.[icommunicatetherapy.com]
  • Patients typically present clinical symptoms between the ages of… Continue Reading BridgeBio Pharma Raises 299 Million January 23, 2019 By Daniel S.[globalgenes.org]
  • Some patients at presentation have focal epileptiform discharges, primarily in the occipital region.[thieme-connect.com]
Movement Disorder
  • 94 Paroxysmal Dyskinesias E-1637 95 Movement Disorders of Infancy E-1646 96 DrugInduced Movement Disorders in Children E-1651 97 Cerebral Palsy E-1660 98 Tics and Tourette Syndrome E-1673 99 Genetic and Metabolic Disorders of the White Matter E-1690 100[books.google.com]
  • Some symptoms include: Tremor – which is often more pronounced on one side Rigidity Akathesia – involuntary movements which may be continual Akinesia – inability to spontaneously move muscles Bradykinesia – slowness in repetitive movements Disordered[icommunicatetherapy.com]
  • disorder Trigonobrachycephaly, bulbous bifid nose, micrognathia, and abnormalities of the hands and feet Friedreich ataxia Aicardi-Goutieres syndrome type 5 Corneodermatoosseous syndrome Ankyloblepharon filiforme adnatum cleft palate Renpenning syndrome[checkrare.com]
  • Hyperkinetic movement disorders in children. In: UpToDate Online Journal [serial online]. Waltham, MA: UpToDate; updated April 2007. Weber S, Tonshoff B.[aetna.com]
Delayed Speech Development
  • speech development Impaired speech and language development Impaired speech development Language delay Language delayed Language development deficit Late-onset speech development Poor language development Speech and language delay Speech and language[rarediseases.info.nih.gov]
Thrombosis
  • Pressure E-1868 106 Spinal Cord Injury E-1882 107 Determination of Brain Death in Infants and Children E-1910 108 Development and Function of the Cerebrovascular System E-1931 109 Arterial Ischemic Stroke in Infants and Children E-1941 110 Sinovenous Thrombosis[books.google.com]
  • G20210A, thrombosis, plasma prothrombin, Factor V Leiden, F5, R506Q, methylenetetrahydrofolate reductase, venous thrombosis, thromboembolism, clotting 0050547 Twin Zygosity (16 markers) Twin Zygosity Testing TWIN ZYG, Fetal zygosity, mono/dizygotic differentiation[aruplab.com]
Distractibility
  • The employee tells the supervisor about his disability and the side effect of the medication he takes, and asks to be moved to a quieter work space to lessen the distractions.[eeoc.gov]
Stroke
  • Older Children E-1849 105 Disorders of Intracranial Pressure E-1868 106 Spinal Cord Injury E-1882 107 Determination of Brain Death in Infants and Children E-1910 108 Development and Function of the Cerebrovascular System E-1931 109 Arterial Ischemic Stroke[books.google.com]
  • The National Institute of Neurological Disorders and Stroke (NINDS) (NINDS) collects and disseminates research information related to neurological disorders. Click on the link to view information on this topic.[rarediseases.info.nih.gov]
  • Spastic Ataxia - Corneal Dystrophy, Spastic Ataxia, Rare Hereditary Ataxia, Rare Ataxia, Recessive Mitochondrial Ataxia Syndrome, Progressive Epilepsy and/or Ataxia With Myoclonus as a Major Feature, Posterior Column Ataxia - Retinitis Pigmentosa, Post-Stroke[crm.diseaseinfosearch.org]
  • These as ‘mini strokes’ cause damage to different areas of the brain. The development of this type of dementia is often not consistently gradual, but has ‘step’ like stages of significant decline followed by periods of stability.[icommunicatetherapy.com]
  • Clinical signs and symptoms of CADASIL include stroke, cognitive defects and/or dementia, migraine, and psychiatric disturbances.[aetna.com]
Neurologic Manifestation
  • Manifestations of Rheumatic Disorders of Childhood E-2172 123 Medulloblastoma E-2211 124 Other Embryonal and Pineal Malignancies of the Central Nervous System E-2221 125 Ependymoma E-2225 126 Pediatric Brain Tumors HighGrade Glioma E-2236 127 Pediatric[books.google.com]
  • Nevertheless, the general physical examination can help identify specific etiologies that have both systemic and neurologic manifestations. No neurologic examination findings are pathognomonic for LGS.[emedicine.medscape.com]
  • Renal manifestations are the second leading cause of morbidity and mortality in individuals with TSC, after the neurologic manifestations. Initial evaluation of individuals with suspected TSC includes renal MRI.[clinicaladvisor.com]
  • Because some patients with MIRAS have presented with ataxia or epilepsy already in childhood, these investigators searched for POLG1 mutations in neurologic manifestations in childhood.[aetna.com]
Language Delays
  • delay Language delayed Language development deficit Late-onset speech development Poor language development Speech and language delay Speech and language difficulties Speech delay [ more ] 0000750 Increased neuronal autofluorescent lipopigment 0002074[rarediseases.info.nih.gov]
  • delay Treatment: Supportive care Congenital disorders of N -glycosylation, type I (pre-Golgi glycosylation defects) Onset: Mostly infancy or childhood Clinical features (some or most of the following): Growth failure, prominent forehead with large ears[merckmanuals.com]
Agitation
  • Severe abnormalities of behaviour, such as disorganized behaviour, agitation, excitement and inactivity or overactivity, may be seen.[euro.who.int]
  • The genetic screening test for CF is usually based on mouthwash samples collected by agitating sucrose or saline in the mouth.[aetna.com]
Delayed Speech and Language Development
  • speech and language development Deficiency of speech development Delayed language development Delayed speech Delayed speech acquisition Delayed speech development Impaired speech and language development Impaired speech development Language delay Language[rarediseases.info.nih.gov]

Workup

  • An EEG is an essential part of the workup for LGS. Neuroimaging is an important part of the search for an underlying etiology (see Workup).[emedicine.medscape.com]
  • It is not always necessary to do the complete metabolic/genetic workup on every child. If the history or exam suggests the possibility of a metabolic or genetic disorder then the treating physician will undertake the evaluation.[childneurologyfoundation.org]
  • […] activator protein PTG and interaction with laforin.[ 21 ] Because of clinically atypical features, some patients with mild Lafora disease could escape a correct diagnosis because adult patients with mild PME traditionally have not undergone diagnostic workup[thieme-connect.com]

Treatment

  • Brand-new chapters in the drug and diet section cover perampanel, ezogabine, and lacosamide, while the existing chapters on major medical treatments have been comprehensively updated to reflect the latest trials and studies.[books.google.com]
  • You may also want to contact a university or tertiary medical center in your area, because these centers tend to see more complex cases and have the latest technology and treatments.[rarediseases.info.nih.gov]
  • Treatment of mucopolysaccharidosis type I (Hurler syndrome) is enzyme replacement with α -l-iduronidase, which effectively halts progression and reverses all non-CNS complications of the disease.[merckmanuals.com]
  • Food and Drug Administration has chosen Wave Life Sciences’ planned phase 2/3 study of suvodirsen, its lead experimental therapy for the treatment of Duchenne muscular dystrophy, to break new ground.[globalgenes.org]
  • In either case, the treatment that gives the child the best chance to achieve complete control of spasms is the treatment of choice.[childneurologyfoundation.org]

Prognosis

  • Long-term prognosis of Lennox-Gastaut syndrome. Epilepsia. 1996. 37 Suppl 3:44-7. [Medline]. Ohtsuka Y, Amano R, Mizukawa M, Ohtahara S. Long-term prognosis of the Lennox-Gastaut syndrome. Jpn J Psychiatry Neurol. 1990 Jun. 44(2):257-64. [Medline].[emedicine.medscape.com]
  • Long-term prognosis in childhood epilepsy: survival and seizure prognosis. Epilepsia 1987 ;28: 324 - 330 13. Berg AT, Shinnar S, Testa FM, Levy SR, Smith SN, Beckerman B. Mortality in childhood-onset epilepsy.[nejm.org]
  • Evolution and Prognosis Prognosis of BECTS is excellent. By the mid teenage children outgrow of the disease in 100% cases [ 45 ].[omicsonline.org]
  • Peripheral Visual Fields: Prognosis: The likely outcome or course of a disease; the chance of recovery or recurrence.[childneurologyfoundation.org]
  • Thus, the results indicate better prognosis in cognitive skills than earlier assumed. There is an apparent decline in motor skills after the age of 20 years.[link.springer.com]

Etiology

  • Etiology LGS can be classified according to its suspected etiology as either idiopathic or symptomatic.[emedicine.medscape.com]
  • Over the last two decades, considerable developments have occurred in the field of PMEs and they have been recognized as a group of syndromes with specific etiologies. 2 Macular cherry red spot is an important diagnostic marker in children with myoclonic[neurologyindia.com]
  • First and foremost is the underlying etiology or cause. Some etiologies will lead to death or mental retardation, whether or not the patient developed infantile spasms.[childneurologyfoundation.org]
  • Ataxia, X-linked Non Progressive Cerebellar Ataxia, X-linked Cerebellar Ataxia, Vitamin B12 Deficiency Ataxia, Toxic Exposure Ataxia, Unclassified Autosomal Dominant Spinocerebellar Ataxia, Thyroid Antibody Ataxia, Sporadic Adult-onset Ataxia of Unknown Etiology[crm.diseaseinfosearch.org]
  • Vadlamudi L, Kjeldsen MJ, Corey LA, Solaas MH, Friis ML, et al. (2006) Analyzing the etiology of benign rolandic epilepsy: a multicenter twin collaboration. Epilepsia 47: 550-555.[omicsonline.org]

Epidemiology

  • From basic mechanisms and epidemiology, through diagnosis and therapy, to quality of life issues, the new edition of this established reference covers every aspect of childhood epilepsy and will continue to be the definitive core text for all professionals[books.google.com]
  • Prevalence and descriptive epidemiology of Lennox-Gastaut syndrome among Atlanta children. Epilepsia. 1997 Dec. 38(12):1283-8. [Medline]. Arzimanoglou A, French J, Blume WT, Cross JH, Ernst JP, Feucht M, et al.[emedicine.medscape.com]
  • Relevant External Links for CLN8 Genetic Association Database (GAD) CLN8 Human Genome Epidemiology (HuGE) Navigator CLN8 Atlas of Genetics and Cytogenetics in Oncology and Haematology: CLN8 No data available for Genatlas for CLN8 Gene Mutations in CLN7[genecards.org]
  • Commission on Epidemiology and Prognosis, International League Against Epilepsy. Guidelines for epidemiologic studies on epilepsy. Epilepsia 1993 ;34: 592 - 596 24.[nejm.org]
  • EPIDEMIOLOGY Incidence and prevalence figures for learning difficulties vary throughout the world and within social class.[jnnp.bmj.com]
Sex distribution
Age distribution

Pathophysiology

  • See the following articles for more information: Pathophysiology The pathophysiology of LGS is not known. No animal models exist. A variety of possible pathophysiologies have been proposed.[emedicine.medscape.com]
  • The current review focuses on the newer advancements in the understanding of the clinical presentation & pathophysiology of BECTS, its genetics and the prognosis.[omicsonline.org]
  • Pathophysiology TSC1 and TSC2 function as tumor suppressor genes. TSC1 encodes the protein hamartin while TSC2 encodes the protein tuberin. Together, hamartin and tuberin form a functional complex, referred to as the TSC1/TSC2 complex.[clinicaladvisor.com]
  • Gaucher disease: the metabolic defect, pathophysiology, phenotypes and natural history. Pediatr Endocrinol Rev 2014; 12 (Suppl. 01) 72-81 37 Park JK, Orvisky E, Tayebi N, et al.[thieme-connect.com]
  • Clinical manifestations, pathophysiology, and diagnosis of atrioventricular (AV) canal defects. UpToDate [online serial]. Waltham, MA: UpToDate; reviewed December 2013. Altman CA.[aetna.com]

Prevention

  • Measures for prevention are becoming increasingly feasible.[esperanzaservices.us]
  • prevent transmission of disease from or to patients).[eeoc.gov]
  • Their function is to prevent some objectively unlikely event, often involving harm to or caused by the patient, which he or she fears might otherwise occur.[euro.who.int]
  • Other important prenatal (and potentially preventable) factors include maternal heroin and cocaine abuse, and HIV encephalopathy. The evidence of prenatal insult may be very subtle.[jnnp.bmj.com]
  • There have been advancements in understanding the genetics of BECTS, however at this point in time cannot be translated into prevention and better management.[omicsonline.org]

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