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Developmental and epileptic encephalopathy, 78(EIEE78; DEE78)

MedGen UID:
1684724
Concept ID:
C5231409
Disease or Syndrome
Synonym: EPILEPTIC ENCEPHALOPATHY, EARLY INFANTILE, 78
 
Gene (location): GABRA2 (4p12)
 
Monarch Initiative: MONDO:0032812
OMIM®: 618557

Definition

Developmental and epileptic encephalopathy-78 (DEE78) is a severe neurologic disorder characterized by onset of refractory seizures in the first days or months of life followed by severely impaired intellectual development. Additional features may include cortical visual impairment, hypotonia, and abnormal movements, such as spasticity (summary by Butler et al., 2018). One family with an attenuated disease course has been reported (Maljevic et al., 2019). For a general phenotypic description and a discussion of genetic heterogeneity of DEE, see 308350. [from OMIM]

Clinical features

From HPO
Cerebral palsy
MedGen UID:
854
Concept ID:
C0007789
Disease or Syndrome
Cerebral palsy describes a group of permanent disorders of the development of movement and posture, causing activity limitation, that are attributed to nonprogressive disturbances that occurred in the developing fetal or infant brain. The motor disorders of cerebral palsy are often accompanied by disturbances of sensation, perception, cognition, communication, and behaviour, by epilepsy, and by secondary musculoskeletal problems.
Chorea
MedGen UID:
3420
Concept ID:
C0008489
Disease or Syndrome
Chorea (Greek for 'dance') refers to widespread arrhythmic involuntary movements of a forcible, jerky and restless fashion. It is a random-appearing sequence of one or more discrete involuntary movements or movement fragments. Movements appear random because of variability in timing, duration or location. Each movement may have a distinct start and end. However, movements may be strung together and thus may appear to flow randomly from one muscle group to another. Chorea can involve the trunk, neck, face, tongue, and extremities.
Spasticity
MedGen UID:
7753
Concept ID:
C0026838
Sign or Symptom
A motor disorder characterized by a velocity-dependent increase in tonic stretch reflexes with increased muscle tone, exaggerated (hyperexcitable) tendon reflexes.
Seizure
MedGen UID:
20693
Concept ID:
C0036572
Sign or Symptom
A seizure is an intermittent abnormality of nervous system physiology characterised by a transient occurrence of signs and/or symptoms due to abnormal excessive or synchronous neuronal activity in the brain.
Status epilepticus
MedGen UID:
11586
Concept ID:
C0038220
Disease or Syndrome
Status epilepticus is a type of prolonged seizure resulting either from the failure of the mechanisms responsible for seizure termination or from the initiation of mechanisms which lead to abnormally prolonged seizures (after time point t1). It is a condition that can have long-term consequences (after time point t2), including neuronal death, neuronal injury, and alteration of neuronal networks, depending on the type and duration of seizures.
Global developmental delay
MedGen UID:
107838
Concept ID:
C0557874
Finding
A delay in the achievement of motor or mental milestones in the domains of development of a child, including motor skills, speech and language, cognitive skills, and social and emotional skills. This term should only be used to describe children younger than five years of age.
Inability to walk
MedGen UID:
107860
Concept ID:
C0560046
Finding
Incapability to ambulate.
Autistic behavior
MedGen UID:
163547
Concept ID:
C0856975
Mental or Behavioral Dysfunction
Persistent deficits in social interaction and communication and interaction as well as a markedly restricted repertoire of activity and interest as well as repetitive patterns of behavior.
Reduced eye contact
MedGen UID:
303190
Concept ID:
C1445953
Finding
Difficulty in looking at another person in the eye.
Severe global developmental delay
MedGen UID:
332436
Concept ID:
C1837397
Finding
A severe delay in the achievement of motor or mental milestones in the domains of development of a child.
CNS hypomyelination
MedGen UID:
892446
Concept ID:
C4025616
Finding
Reduced amount of myelin in the central nervous system resulting from defective myelinogenesis.
Hypotonia
MedGen UID:
10133
Concept ID:
C0026827
Finding
Hypotonia is an abnormally low muscle tone (the amount of tension or resistance to movement in a muscle). Even when relaxed, muscles have a continuous and passive partial contraction which provides some resistance to passive stretching. Hypotonia thus manifests as diminished resistance to passive stretching. Hypotonia is not the same as muscle weakness, although the two conditions can co-exist.
Generalized hypotonia
MedGen UID:
346841
Concept ID:
C1858120
Finding
Generalized muscular hypotonia (abnormally low muscle tone).
Neonatal hypotonia
MedGen UID:
412209
Concept ID:
C2267233
Disease or Syndrome
Muscular hypotonia (abnormally low muscle tone) manifesting in the neonatal period.
Microcephaly
MedGen UID:
1644158
Concept ID:
C4551563
Finding
Head circumference below 2 standard deviations below the mean for age and gender.
Hypothermia
MedGen UID:
5720
Concept ID:
C0020672
Finding
Reduced body temperature due to failed thermoregulation.
Cerebral visual impairment
MedGen UID:
890568
Concept ID:
C4048268
Pathologic Function
A form of loss of vision caused by damage to the visual cortex rather than a defect in the eye.

Professional guidelines

PubMed

Bozarth XL, Lopez J, Fang H, Lee-Eng J, Duan Z, Deng X
Genes (Basel) 2023 Mar 31;14(4) doi: 10.3390/genes14040852. PMID: 37107610Free PMC Article
Strzelczyk A, Schubert-Bast S
CNS Drugs 2021 Jan;35(1):61-83. Epub 2021 Jan 21 doi: 10.1007/s40263-020-00784-8. PMID: 33479851Free PMC Article
Bromley R, Weston J, Adab N, Greenhalgh J, Sanniti A, McKay AJ, Tudur Smith C, Marson AG
Cochrane Database Syst Rev 2014 Oct 30;2014(10):CD010236. doi: 10.1002/14651858.CD010236.pub2. PMID: 25354543Free PMC Article

Recent clinical studies

Etiology

Dreier JW, Bjørk MH, Alvestad S, Gissler M, Igland J, Leinonen MK, Sun Y, Zoega H, Cohen JM, Furu K, Tomson T, Christensen J
JAMA Neurol 2023 Jun 1;80(6):568-577. doi: 10.1001/jamaneurol.2023.0674. PMID: 37067807Free PMC Article
Nissenkorn A, Kluger G, Schubert-Bast S, Bayat A, Bobylova M, Bonanni P, Ceulemans B, Coppola A, Di Bonaventura C, Feucht M, Fuchs A, Gröppel G, Heimer G, Herdt B, Kulikova S, Mukhin K, Nicassio S, Orsini A, Panagiotou M, Pringsheim M, Puest B, Pylaeva O, Ramantani G, Tsekoura M, Ricciardelli P, Lerman Sagie T, Stark B, Striano P, van Baalen A, De Wachter M, Cerulli Irelli E, Cuccurullo C, von Stülpnagel C, Russo A
Epilepsia 2023 Apr;64(4):866-874. Epub 2023 Feb 20 doi: 10.1111/epi.17530. PMID: 36734057
Glass HC, Soul JS, Chang T, Wusthoff CJ, Chu CJ, Massey SL, Abend NS, Lemmon M, Thomas C, Numis AL, Guillet R, Sturza J, McNamara NA, Rogers EE, Franck LS, McCulloch CE, Shellhaas RA
JAMA Neurol 2021 Jul 1;78(7):817-825. doi: 10.1001/jamaneurol.2021.1437. PMID: 34028496Free PMC Article
Strzelczyk A, Schubert-Bast S
CNS Drugs 2021 Jan;35(1):61-83. Epub 2021 Jan 21 doi: 10.1007/s40263-020-00784-8. PMID: 33479851Free PMC Article
Ebbing C, Kessler J, Moster D, Rasmussen S
Ultrasound Obstet Gynecol 2020 Apr;55(4):510-515. doi: 10.1002/uog.20359. PMID: 31132166

Diagnosis

Dreier JW, Bjørk MH, Alvestad S, Gissler M, Igland J, Leinonen MK, Sun Y, Zoega H, Cohen JM, Furu K, Tomson T, Christensen J
JAMA Neurol 2023 Jun 1;80(6):568-577. doi: 10.1001/jamaneurol.2023.0674. PMID: 37067807Free PMC Article
Dirik MA, Sanlidag B
Childs Nerv Syst 2023 Mar;39(3):775-780. Epub 2022 Nov 2 doi: 10.1007/s00381-022-05724-z. PMID: 36323954
Beck VC, Isom LL, Berg AT
J Pediatr 2021 Oct;237:41-49.e1. Epub 2021 Jun 26 doi: 10.1016/j.jpeds.2021.06.034. PMID: 34181986Free PMC Article
Pavone P, Corsello G, Ruggieri M, Marino S, Marino S, Falsaperla R
Ital J Pediatr 2018 May 15;44(1):54. doi: 10.1186/s13052-018-0491-z. PMID: 29764460Free PMC Article
Dussaule C, Masnou P, Nasser G, Archambaud F, Cauquil-Michon C, Gagnepain JP, Bouilleret V, Denier C
J Neurol 2017 Dec;264(12):2495-2505. Epub 2017 Mar 17 doi: 10.1007/s00415-017-8456-5. PMID: 28314978

Therapy

Dreier JW, Bjørk MH, Alvestad S, Gissler M, Igland J, Leinonen MK, Sun Y, Zoega H, Cohen JM, Furu K, Tomson T, Christensen J
JAMA Neurol 2023 Jun 1;80(6):568-577. doi: 10.1001/jamaneurol.2023.0674. PMID: 37067807Free PMC Article
Nissenkorn A, Kluger G, Schubert-Bast S, Bayat A, Bobylova M, Bonanni P, Ceulemans B, Coppola A, Di Bonaventura C, Feucht M, Fuchs A, Gröppel G, Heimer G, Herdt B, Kulikova S, Mukhin K, Nicassio S, Orsini A, Panagiotou M, Pringsheim M, Puest B, Pylaeva O, Ramantani G, Tsekoura M, Ricciardelli P, Lerman Sagie T, Stark B, Striano P, van Baalen A, De Wachter M, Cerulli Irelli E, Cuccurullo C, von Stülpnagel C, Russo A
Epilepsia 2023 Apr;64(4):866-874. Epub 2023 Feb 20 doi: 10.1111/epi.17530. PMID: 36734057
Dirik MA, Sanlidag B
Childs Nerv Syst 2023 Mar;39(3):775-780. Epub 2022 Nov 2 doi: 10.1007/s00381-022-05724-z. PMID: 36323954
Glass HC, Soul JS, Chang T, Wusthoff CJ, Chu CJ, Massey SL, Abend NS, Lemmon M, Thomas C, Numis AL, Guillet R, Sturza J, McNamara NA, Rogers EE, Franck LS, McCulloch CE, Shellhaas RA
JAMA Neurol 2021 Jul 1;78(7):817-825. doi: 10.1001/jamaneurol.2021.1437. PMID: 34028496Free PMC Article
Strzelczyk A, Schubert-Bast S
CNS Drugs 2021 Jan;35(1):61-83. Epub 2021 Jan 21 doi: 10.1007/s40263-020-00784-8. PMID: 33479851Free PMC Article

Prognosis

Bozarth XL, Lopez J, Fang H, Lee-Eng J, Duan Z, Deng X
Genes (Basel) 2023 Mar 31;14(4) doi: 10.3390/genes14040852. PMID: 37107610Free PMC Article
Dreier JW, Bjørk MH, Alvestad S, Gissler M, Igland J, Leinonen MK, Sun Y, Zoega H, Cohen JM, Furu K, Tomson T, Christensen J
JAMA Neurol 2023 Jun 1;80(6):568-577. doi: 10.1001/jamaneurol.2023.0674. PMID: 37067807Free PMC Article
Li J, Ji Z, Yu J, Ren J, Yang F, Bian L, Zhi X, Li G, Zhang H
Stroke Vasc Neurol 2023 Aug;8(4):292-300. Epub 2023 Jan 6 doi: 10.1136/svn-2022-001979. PMID: 36609545Free PMC Article
Salvati A, Bonaventura E, Sesso G, Pasquariello R, Sicca F
Seizure 2021 Oct;91:425-436. Epub 2021 Jul 21 doi: 10.1016/j.seizure.2021.07.020. PMID: 34325301
Pavone P, Corsello G, Ruggieri M, Marino S, Marino S, Falsaperla R
Ital J Pediatr 2018 May 15;44(1):54. doi: 10.1186/s13052-018-0491-z. PMID: 29764460Free PMC Article

Clinical prediction guides

Bozarth XL, Lopez J, Fang H, Lee-Eng J, Duan Z, Deng X
Genes (Basel) 2023 Mar 31;14(4) doi: 10.3390/genes14040852. PMID: 37107610Free PMC Article
Dirik MA, Sanlidag B
Childs Nerv Syst 2023 Mar;39(3):775-780. Epub 2022 Nov 2 doi: 10.1007/s00381-022-05724-z. PMID: 36323954
Di Nora A, Costanza G, Pizzo F, Oliva CF, Di Mari A, Greco F, Pavone P
Acta Neurol Belg 2022 Feb;122(1):153-162. Epub 2021 Sep 1 doi: 10.1007/s13760-021-01774-3. PMID: 34471972Free PMC Article
Glass HC, Soul JS, Chang T, Wusthoff CJ, Chu CJ, Massey SL, Abend NS, Lemmon M, Thomas C, Numis AL, Guillet R, Sturza J, McNamara NA, Rogers EE, Franck LS, McCulloch CE, Shellhaas RA
JAMA Neurol 2021 Jul 1;78(7):817-825. doi: 10.1001/jamaneurol.2021.1437. PMID: 34028496Free PMC Article
Strzelczyk A, Schubert-Bast S
CNS Drugs 2021 Jan;35(1):61-83. Epub 2021 Jan 21 doi: 10.1007/s40263-020-00784-8. PMID: 33479851Free PMC Article

Recent systematic reviews

Salvati A, Bonaventura E, Sesso G, Pasquariello R, Sicca F
Seizure 2021 Oct;91:425-436. Epub 2021 Jul 21 doi: 10.1016/j.seizure.2021.07.020. PMID: 34325301
Angriman M, Cortese S, Bruni O
Sleep Med Rev 2017 Aug;34:34-45. Epub 2016 Jul 1 doi: 10.1016/j.smrv.2016.06.008. PMID: 27519964
Bromley R, Weston J, Adab N, Greenhalgh J, Sanniti A, McKay AJ, Tudur Smith C, Marson AG
Cochrane Database Syst Rev 2014 Oct 30;2014(10):CD010236. doi: 10.1002/14651858.CD010236.pub2. PMID: 25354543Free PMC Article

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