Skip to main content
Top
Published in: Neurological Research and Practice 1/2019

Open Access 01-12-2019 | Epilepsy | Research article

Genotypes and phenotypes of patients with Lafora disease living in Germany

Authors: David Brenner, Tobias Baumgartner, Sarah von Spiczak, Jan Lewerenz, Roger Weis, Anja Grimmer, Petra Gaspirova, Claudia D. Wurster, Wolfram S. Kunz, Jan Wagner, Berge A. Minassian, Christian E. Elger, Albert C. Ludolph, Saskia Biskup, Dennis Döcker

Published in: Neurological Research and Practice | Issue 1/2019

Login to get access

Abstract

Background

Lafora progressive myoclonus epilepsy (Lafora disease) is a rare, usually childhood-onset, fatal neurodegenerative disease caused by biallelic mutations in EPM2A (Laforin) or EPM2B (NHLRC1; Malin). The epidemiology of Lafora disease in Germany is largely unknown. The objective of this retrospective case series is to characterize the genotypes and phenotypes of patients with Lafora disease living in Germany.

Methods

The patients described in this case series initially had the suspected clinical diagnosis of Lafora disease, or unclassified progressive myoclonus epilepsy. Molecular genetic diagnostics including next generation sequencing-based diagnostic panel analysis or whole exome sequencing was performed.

Results

The parents of four out of the 11 patients are nonconsanguineous and of German origin while the other patients had consanguineous parents. Various variants were found in EPM2A (six patients) and in EPM2B (five patients). Eight variants have not been reported in the literature so far. The patients bearing novel variants had typical disease onset during adolescence and show classical disease courses.

Conclusions

This is the first larger case series of Lafora patients in Germany. Our data enable an approximation of the prevalence of manifest Lafora disease in Germany to 1,69 per 10 million people. Broader application of gene panel or whole-exome diagnostics helps clarifying unclassified progressive myoclonus epilepsy and establish an early diagnosis, which will be even more important as causal therapy approaches have been developed and are soon to be tested in a phase I study.
Appendix
Available only for authorised users
Literature
1.
go back to reference Minassian, B. A., Lee, J. R., Herbrick, J.-A., et al. (1998). Mutations in a gene encoding a novel protein tyrosine phosphatase cause progressive myoclonus epilepsy. Nature Genetics, 20, 171–174.CrossRef Minassian, B. A., Lee, J. R., Herbrick, J.-A., et al. (1998). Mutations in a gene encoding a novel protein tyrosine phosphatase cause progressive myoclonus epilepsy. Nature Genetics, 20, 171–174.CrossRef
2.
go back to reference Chan, E. M., Young, E. J., Ianzano, L., et al. (2003). Mutations in NHLRC1 cause progressive myoclonus epilepsy. Nature Genetics, 35, 125–127.CrossRef Chan, E. M., Young, E. J., Ianzano, L., et al. (2003). Mutations in NHLRC1 cause progressive myoclonus epilepsy. Nature Genetics, 35, 125–127.CrossRef
4.
go back to reference Pederson, B. A., Turnbull, J., Epp, J. R., et al. (2013). Inhibiting glycogen synthesis prevents Lafora disease in a mouse model. Annals of Neurology, 74, 297–300.PubMedPubMedCentral Pederson, B. A., Turnbull, J., Epp, J. R., et al. (2013). Inhibiting glycogen synthesis prevents Lafora disease in a mouse model. Annals of Neurology, 74, 297–300.PubMedPubMedCentral
5.
go back to reference Ianzano, L., Zhang, J., Chan, E. M., et al. (2005). Lafora progressive myoclonus epilepsy mutation database-EPM2A and NHLRC1 (EMP2B) genes. Human Mutation, 26, 397–397. Wiley.CrossRef Ianzano, L., Zhang, J., Chan, E. M., et al. (2005). Lafora progressive myoclonus epilepsy mutation database-EPM2A and NHLRC1 (EMP2B) genes. Human Mutation, 26, 397–397. Wiley.CrossRef
6.
go back to reference Gómez-Garre, P., Sanz, Y., Rodríguez De Córdoba, S. R., & Serratosa, J. M. (2000). Mutational spectrum of the EPM2A gene in progressive myoclonus epilepsy of Lafora: High degree of allelic heterogeneity and prevalence of deletions. European Journal of Human Genetics, 8, 946–954.CrossRef Gómez-Garre, P., Sanz, Y., Rodríguez De Córdoba, S. R., & Serratosa, J. M. (2000). Mutational spectrum of the EPM2A gene in progressive myoclonus epilepsy of Lafora: High degree of allelic heterogeneity and prevalence of deletions. European Journal of Human Genetics, 8, 946–954.CrossRef
7.
go back to reference Lanoiselée, H.-M., Genton, P., Lesca, G., Brault, F., & De Toffol, B. (2014). Are c.436G>A mutations less severe forms of Lafora disease? A case report. Epilepsy & Behavior Case Reports, 2, 19–21. Elsevier.CrossRef Lanoiselée, H.-M., Genton, P., Lesca, G., Brault, F., & De Toffol, B. (2014). Are c.436G>A mutations less severe forms of Lafora disease? A case report. Epilepsy & Behavior Case Reports, 2, 19–21. Elsevier.CrossRef
8.
go back to reference Ferlazzo, E., Canafoglia, L., Michelucci, R., et al. (2014). Mild Lafora disease: Clinical, neurophysiologic, and genetic findings. Epilepsia, 55, e129–e133.CrossRef Ferlazzo, E., Canafoglia, L., Michelucci, R., et al. (2014). Mild Lafora disease: Clinical, neurophysiologic, and genetic findings. Epilepsia, 55, e129–e133.CrossRef
9.
go back to reference Nicolescu, R. C., Al-Khawaga, S., Minassian, B. A., & Hussain, K. (2019). Diabetes mellitus in a patient with Lafora disease: Possible links with pancreatic β-cell dysfunction and insulin resistance. Frontiers in Pediatrics, 6, 424.CrossRef Nicolescu, R. C., Al-Khawaga, S., Minassian, B. A., & Hussain, K. (2019). Diabetes mellitus in a patient with Lafora disease: Possible links with pancreatic β-cell dysfunction and insulin resistance. Frontiers in Pediatrics, 6, 424.CrossRef
10.
go back to reference Robitaille, Y., Carpenter, S., Karpati, G., & DiMauro, S. D. (1980). A distinct form of adult polyglucosan body disease with massive involvement of central and peripheral neuronal processes and astrocytes: A report of four cases and a review of the occurrence of polyglucosan bodies in other conditions such as Lafora’s disease and normal ageing. Brain, 103, 315–336.CrossRef Robitaille, Y., Carpenter, S., Karpati, G., & DiMauro, S. D. (1980). A distinct form of adult polyglucosan body disease with massive involvement of central and peripheral neuronal processes and astrocytes: A report of four cases and a review of the occurrence of polyglucosan bodies in other conditions such as Lafora’s disease and normal ageing. Brain, 103, 315–336.CrossRef
Metadata
Title
Genotypes and phenotypes of patients with Lafora disease living in Germany
Authors
David Brenner
Tobias Baumgartner
Sarah von Spiczak
Jan Lewerenz
Roger Weis
Anja Grimmer
Petra Gaspirova
Claudia D. Wurster
Wolfram S. Kunz
Jan Wagner
Berge A. Minassian
Christian E. Elger
Albert C. Ludolph
Saskia Biskup
Dennis Döcker
Publication date
01-12-2019
Publisher
BioMed Central
Published in
Neurological Research and Practice / Issue 1/2019
Electronic ISSN: 2524-3489
DOI
https://doi.org/10.1186/s42466-019-0040-2

Other articles of this Issue 1/2019

Neurological Research and Practice 1/2019 Go to the issue

Standard operating procedure

Aneurysmatic subarachnoid haemorrhage