IRF2BPL as a novel causative gene for progressive myoclonus epilepsy

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  • Elena Gardella
  • Roberto Michelucci
  • Hanne M. Christensen
  • Christina D. Fenger
  • Chiara Reale
  • Patrizia Riguzzi
  • Elena Pasini
  • Luca Albini-Riccioli
  • Valentina Papa
  • Maria Pia Foschini
  • Giovanna Cenacchi
  • Francesca Furia
  • Dragan Marjanovic
  • Trine B. Hammer
  • Rikke S. Møller
  • Rubboli, Guido

IRF2BPL has recently been described as a novel cause of neurodevelopmental disorders with multisystemic regression, epilepsy, cerebellar symptoms, dysphagia, dystonia, and pyramidal signs. We describe a novel IRF2BPL phenotype consistent with progressive myoclonus epilepsy (PME) in three novel subjects and review the features of the 31 subjects with IRF2BPL-related disorders previously reported. Our three probands, aged 28–40 years, harbored de novo nonsense variants in IRF2BPL (c.370C > T, p.[Gln124*] and c.364C > T; p.[Gln122*], respectively). From late childhood/adolescence, they presented with severe myoclonus epilepsy, stimulus-sensitive myoclonus, and progressive cognitive, speech, and cerebellar impairment, consistent with a typical PME syndrome. The skin biopsy revealed massive intracellular glycogen inclusions in one proband, suggesting a similar pathogenic pathway to other storage disorders. Whereas the two older probands were severely affected, the younger proband had a milder PME phenotype, partially overlapping with some of the previously reported IRF2BPL cases, suggesting that some of them might be unrecognized PME. Interestingly, all three patients harbored protein-truncating variants clustered in a proximal, highly conserved gene region around the “coiled-coil” domain. Our data show that PME can be an additional phenotype within the spectrum of IRF2BPL-related disorders and suggest IRF2BPL as a novel causative gene for PME.

Original languageEnglish
JournalEpilepsia
Volume64
Issue number8
Pages (from-to)e170-e176
Number of pages7
ISSN0013-9580
DOIs
Publication statusPublished - 2023

Bibliographical note

Publisher Copyright:
© 2023 The Authors. Epilepsia published by Wiley Periodicals LLC on behalf of International League Against Epilepsy.

    Research areas

  • ataxia, cerebellar signs, IRF2BPL, neurodevelopmental disorder, progressive myoclonus epilepsy

ID: 366304682