Lafora disease: Severe phenotype associated with homozygous deletion of the NHLRC1 gene

• Published in: Journal of the neurological sciences Vol. 325; no. 1; pp. 170 - 173
• Main Authors: Kecmanović, Miljana, Jović, Nebojša, Čukić, Mirjana, Keckarević-Marković, Milica, Keckarević, Dušan, Stevanović, Galina, Romac, Stanka
• Format: Journal Article
• Language: English
• Published: Amsterdam Elsevier B.V 15-02-2013; Elsevier
• Subjects: Age; Biological and medical sciences; Carrier Proteins - genetics; Degenerative and inherited degenerative diseases of the nervous system. Leukodystrophies. Prion diseases; Female; Homozygote; Humans; Lafora disease; Lafora Disease - diagnosis; Lafora Disease - genetics; Large deletion; Medical sciences; Neurology; NHLRC1; Phenotype; Sequence Deletion - genetics; Severe phenotype; Severity of Illness Index; Young Adult; Severe phenotype; NHLRC1; Large deletion; Lafora disease; Human; Nervous system diseases; Phenotype; Pathogenesis; Deletion; Homozygosity; Genetic determinism
• ISSN: 0022-510X; 1878-5883
• DOI: 10.1016/j.jns.2012.12.006

Abstract Lafora disease (LD) is a severe, autosomal recessive, latechildhood- to teenage-onset, progressive myoclonic epilepsy. It is due to either EPM2A or NHLRC1 mutations. We describe a patient with homozygous deletion encompassing the entire NHLRC1 gene, not previously reported, and with clinical course more progressive than in the most patients with NHLRC1 mutations. The diagnosis of LD in our patient was based on the typical clinic, neurophysiological presentation, as well as skin biopsy followed by molecular genetics findings. She developed normally until the age of 15, when she had her first occipital and generalized seizures. Four years after the first seizure the patient became bedridden, demented and presented with severe clinical condition. She died of pneumonia at age 20. This report is the first case of homozygosity for NHLRC1 deletion and thus adds to mutational heterogeneity of LD. Besides, it widens the spectrum of LD patients with severe phenotype and NHLRC1 mutations.