PRRT2-related disorders: Further PKD and ICCA cases and review of the literature

Felicitas Becker, Julian Schubert, Pasquale Striano, Anna Kaisa Anttonen, Elina Liukkonen, Eija Gaily, Christian Gerloff, Stephan Müller, Nicole Heußinger, Christoph Kellinghaus, Angela Robbiano, Anne Polvi, Simone Zittel, Tim J. Von Oertzen, Kevin Rostasy, Ludger Schöls, Tom Warner, Alexander Münchau, Anna Elina Lehesjoki, Federico ZaraHolger Lerche, Yvonne G. Weber*

*Corresponding author for this work
49 Citations (Scopus)

Abstract

Recent studies reported mutations in the gene encoding the proline-rich transmembrane protein 2 (PRRT2) to be causative for paroxysmal kinesigenic dyskinesia (PKD), PKD combined with infantile seizures (ICCA), and benign familial infantile seizures (BFIS). PRRT2 is a presynaptic protein which seems to play an important role in exocytosis and neurotransmitter release. PKD is the most common form of paroxysmal movement disorder characterized by recurrent brief involuntary hyperkinesias triggered by sudden movements. Here, we sequenced PRRT2 in 14 sporadic and 8 familial PKD and ICCA cases of Caucasian origin and identified three novel mutations (c.919C[T/p.Gln307*, c.388delG/p.Ala130- Profs*46, c.884G[A/p.Arg295Gln) predicting two truncated proteins and one probably damaging point mutation. A review of all published cases is also included. PRRT2 mutations occur more frequently in familial forms of PRRT2-related syndromes (80-100 %) than in sporadic cases (33-46 %) suggesting further heterogeneity in the latter. PRRT2 mutations were rarely described in other forms of paroxysmal dyskinesias deviating from classical PKD, as we report here in one ICCA family without kinesigenic triggers. Mutations are exclusively found in two exons of the PRRT2 gene at a high rate across all syndromes and with one major mutation (c.649dupC) in a mutational hotspot of nine cytosines, which is responsible for 57 % of all cases in all phenotypes. We therefore propose that genetic analysis rapidly performed in early stages of the disease is highly cost-effective and can help to avoid further unnecessary diagnostic and therapeutic interventions.

Original languageEnglish
JournalJournal of Neurology
Volume260
Issue number5
Pages (from-to)1234-1244
Number of pages11
ISSN0340-5354
DOIs
Publication statusPublished - 01.05.2013

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