The hidden genetics of epilepsy-a clinically important new paradigm
- PMID: 24733163
- DOI: 10.1038/nrneurol.2014.62
The hidden genetics of epilepsy-a clinically important new paradigm
Abstract
Understanding the aetiology of epilepsy is essential both for clinical management of patients and for conducting neurobiological research that will direct future therapies. The aetiology of epilepsy was formerly regarded as unknown in about three-quarters of patients; however, massively parallel gene-sequencing studies, conducted in a framework of international collaboration, have yielded a bounty of discoveries that highlight the importance of gene mutations in the aetiology of epilepsy. These data, coupled with clinical genetic studies, suggest a new paradigm for use in the clinic: many forms of epilepsy are likely to have a genetic basis. Enquiry about a genetic cause of epilepsy is readily overlooked in the clinic for a number of understandable but remediable reasons, not least an incomplete understanding of its genetic architecture. In addition, the importance of de novo mutagenesis is often underappreciated, particularly in the epileptic encephalopathies. Other genomic surprises are worth emphasizing, such as the emerging evidence of a genetic contribution to focal epilepsies-long regarded as acquired conditions-and the complex role of copy number variation. The importance of improved understanding of the genetics of the epilepsies is confirmed by the positive outcomes, in terms of treatment selection and counselling, of receiving a genetic diagnosis.
Similar articles
-
Advancing epilepsy genetics in the genomic era.Genome Med. 2015 Aug 25;7(1):91. doi: 10.1186/s13073-015-0214-7. Genome Med. 2015. PMID: 26302787 Free PMC article. Review.
-
Genetic investigations of the epileptic encephalopathies: Recent advances.Prog Brain Res. 2016;226:35-60. doi: 10.1016/bs.pbr.2016.04.006. Epub 2016 May 31. Prog Brain Res. 2016. PMID: 27323938 Review.
-
Progress from genome-wide association studies and copy number variant studies in epilepsy.Curr Opin Neurol. 2016 Apr;29(2):158-67. doi: 10.1097/WCO.0000000000000296. Curr Opin Neurol. 2016. PMID: 26886358 Review.
-
Investigating the genetic basis of fever-associated syndromic epilepsies using copy number variation analysis.Epilepsia. 2015 Mar;56(3):e26-32. doi: 10.1111/epi.12920. Epub 2015 Feb 17. Epilepsia. 2015. PMID: 25690317 Free PMC article.
-
The contribution of next generation sequencing to epilepsy genetics.Expert Rev Mol Diagn. 2015;15(12):1531-8. doi: 10.1586/14737159.2015.1113132. Epub 2015 Nov 13. Expert Rev Mol Diagn. 2015. PMID: 26565596 Review.
Cited by
-
Epilepsy-Related Voltage-Gated Sodium Channelopathies: A Review.Front Pharmacol. 2020 Aug 18;11:1276. doi: 10.3389/fphar.2020.01276. eCollection 2020. Front Pharmacol. 2020. PMID: 33013363 Free PMC article. Review.
-
Dravet syndrome in South African infants: Tools for an early diagnosis.Seizure. 2018 Nov;62:99-105. doi: 10.1016/j.seizure.2018.09.010. Epub 2018 Sep 14. Seizure. 2018. PMID: 30321769 Free PMC article.
-
Genetic Diagnosis Spectrum and Multigenic Burden of Exome-Level Rare Variants in a Childhood Epilepsy Cohort.Front Genet. 2021 Dec 21;12:782419. doi: 10.3389/fgene.2021.782419. eCollection 2021. Front Genet. 2021. PMID: 34992632 Free PMC article.
-
Impact of Genetic Testing on Therapeutic Decision-Making in Childhood-Onset Epilepsies-a Study in a Tertiary Epilepsy Center.Neurotherapeutics. 2022 Jul;19(4):1353-1367. doi: 10.1007/s13311-022-01264-1. Epub 2022 Jun 20. Neurotherapeutics. 2022. PMID: 35723786 Free PMC article.
-
Detection rate of causal variants in severe childhood epilepsy is highest in patients with seizure onset within the first four weeks of life.Orphanet J Rare Dis. 2018 May 2;13(1):71. doi: 10.1186/s13023-018-0812-8. Orphanet J Rare Dis. 2018. PMID: 29720203 Free PMC article.
References
Publication types
MeSH terms
LinkOut - more resources
Full Text Sources
Other Literature Sources
Medical