EEG features and epilepsy in MECP2-mutated patients with the Zappella variant of Rett syndrome

Autor: Beatrice Guerra, Vanessa Guerri, Michele Zappella, Alessandra Renieri, Claudio De Felice, Sabrina Buoni, Raffaella Zannolli, Stefania Casali, J. Hayek, Barbara Pucci, Francesca Mari, Letizia Corbini, Anna De Nicola
Rok vydání: 2010
Předmět:
Zdroj: Clinical Neurophysiology. 121:652-657
ISSN: 1388-2457
DOI: 10.1016/j.clinph.2010.01.003
Popis: Objective To assess the presence/absence of peculiar EEG features and epilepsy in MECP2-mutated Rett patients with the Zappella–Rett variant (Z-RTT) also known as preserved speech variant. Methods Retrospective analysis of 16 (age 19.4±8.4years; range 8–38years) MECP2 mutated Z-RTT cases, including 11 high or intermediate performance (HIP), and five low-performance (LP) patients was performed. Peculiar EEG features were analyzed as a function of the HIP or LP Z-RTT categories: (1) centro-temporal spikes, (2) multifocal EEG activity, (3) EEG encephalopathy (i.e. multifocal EEG activity associated with the presence of background slowing and diffuse slow activity), (4) spindles and K-complex. Furthermore, we assessed the occurrence of epilepsy. Correlations between electroclinical features and category of Z-RTT genotype (missense or truncation mutation) were also tested. Results The Z-RTT HIP group showed a very abnormal EEG (presence of centro-temporal spikes: p =0.004808), although the cases studied were not epileptogenic and did not develop encephalopathy. The LP group showed multifocal EEG activity ( p =0.000229), EEG encephalopathy ( p =0.000229) and epilepsy ( p =0.299451). No significant differences between the prevalence of centro-temporal spikes, multifocal EEG activity, EEG encephalopathy, and epilepsy between the patients with the truncation or missense mutation were observed. Conclusions EEG electrophysiological patterns and epileptogenic susceptibility differ in Z-RTT according to the level of performance (i.e. HIP or LP). Significance These results indicate that HIP and LP Z-RTT should be considered as distinct entities, not only on a clinical basis, but also as it concerns EEG features and epileptogenic susceptibility. These results could offer support in the practical management of patients and family counseling.
Databáze: OpenAIRE