A de novo missense pathogenic mutation c.2415C> G (p.Asp805Glu) in ATP1A3 gene in a patient with alternating hemiplegia of childhood with favorable response to biperiden hydrochloride

Authors

DOI:

https://doi.org/10.11606/issn.2176-7262.rmrp.2021.167265

Keywords:

Hemiplegia, Cognitive Dysfunction, Seizures, Biperiden

Abstract

Alternating hemiplegia of childhood is a severe neurological disorder and a rare disease (1 in 100,000 newborns), characterized by repeated transient attacks of episodic hemiplegia or tetraplegia that can last minutes to hours, accompanied by other paroxysmal symptoms such as oculomotor and autonomic abnormalities, movement disorders such as ataxia, progressive cognitive impairment, seizures, dystonia, and chorea. Current treatments are largely symptomatic. In this case report, we present a female patient, 18 years old, who presented the first apparent episode of seizure with ocular version at ten months of age. The electroencephalogram and CT scan revealed no abnormalities, and several medications such as phenobarbital, carbamazepine, sodium valproate, topiramate, flunarizine dihydrochloride, clonazepam, cyproheptadine and pizotifen were administered, all without result. Due to the extrapyramidal symptoms, the patient started using biperidene, showing improvement in dystonia and the number of hemiplegic seizures. At age 13, she was diagnosed with Alternating hemiplegia of Childhood in the pathogenic missense de novo mutation c.2415C>G (p.Asp805Glu) in the ATP1A3 gene showing a good response to treatment with biperidene hydrochloride.

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Author Biographies

  • Gabriela Cabrera Garbuio, Centro Universitário Estácio de Ribeirão Preto

    Acadêmico

  • Jéssica Rezende Mio, Centro Universitário Estácio de Ribeirão Preto
    Acadêmica
  • Letícia Cassaro Feltrin, Centro Universitário Estácio de Ribeirão Preto
    Acadêmica
  • Marina Soccal Silva , Centro Universitário Estácio de Ribeirão Preto
    Acadêmica
  • Zumira Aparecida Carneiro, Centro Universitário Estácio de Ribeirão Preto

    Professor Doutor

  • Charles Marques Lourenço, Centro Universitário Estácio de Ribeirão Preto

    Professor Doutor

References

Yang X, Gao H, Zhang J, Xu X, Liu X, Wu X et al. ATP1A3 Mutations and Genotype-Phenotype Correlation of Alternating Hemiplegia of Childhood in Chinese Patients. PLOS ONE 2014; 9: e97274.

Gergont A, Kaciński M. Alternating hemiplegia of childhood: New diagnostic options. Neurol Neurochir Pol 2014; 48: 130–135.

Masoud M, Prange L, Wuchich J, Hunanyan A, Mikati MA. Diagnosis and Treatment of Alternating Hemiplegia of Childhood. Curr Treat Options Neurol 2017; 19: 8.

Ishii A, Saito Y, Mitsui J, Ishiura H, Yoshimura J, Arai H et al. Identification of ATP1A3 mutations by exome sequencing as the cause of alternating hemiplegia of childhood in Japanese patients. PloS One 2013; 8: e56120.

Heinzen EL, Swoboda KJ, Hitomi Y, Gurrieri F, Nicole S, de Vries B et al. De novo mutations in ATP1A3 cause alternating hemiplegia of childhood. Nat Genet 2012; 44: 1030–1034.

Schirinzi T, Graziola F, Nicita F, Travaglini L, Stregapede F, Valeriani M et al. Childhood Rapid-Onset Ataxia: Expanding the Phenotypic Spectrum of ATP1A3 Mutations. Cerebellum Lond Engl 2018; 17: 489–493.

Simmons CQ, Thompson CH, Cawthon BE, Westlake G, Swoboda KJ, Kiskinis E et al. Direct evidence of impaired neuronal Na/K-ATPase pump function in alternating hemiplegia of childhood. Neurobiol Dis 2018; 115: 29–38.

Rosewich H, Sweney MT, DeBrosse S, Ess K, Ozelius L, Andermann E et al. Research conference summary from the 2014 International Task Force on ATP1A3-Related Disorders. Neurol Genet 2017; 3: e139.

Sweney MT, Newcomb TM, Swoboda KJ. The expanding spectrum of neurological phenotypes in children with ATP1A3 mutations, Alternating Hemiplegia of Childhood, Rapid-onset Dystonia-Parkinsonism, CAPOS and beyond. Pediatr Neurol 2015; 52: 56–64.

More Than a Decade of Misdiagnosis of Alternating Hemiplegia of Childhood with Catastrophic Outcome. https://www.hindawi.com/journals/crim/2017/5769837/ (accessed 2 May2019).

Mikati MA, Kramer U, Zupanc ML, Shanahan RJ. Alternating hemiplegia of childhood: clinical manifestations and long-term outcome. Pediatr Neurol 2000; 23: 134–141.

Incorpora G, Pavone P, Cocuzza M, Privitera M, Pavone L, Ruggieri M. Neonatal onset of bath-induced alternating hemiplegia of childhood. Eur J Paediatr Neurol EJPN Off J Eur Paediatr Neurol Soc 2010; 14: 192–193.

Incorpora G, Pavone P, Polizzi A, Cocuzza M, Privitera M, Pavone L et al. An 11-year follow-up study of neonatal-onset, bath-induced alternating hemiplegia of childhood in twins. J Child Neurol 2012; 27: 657–662.

Heinzen EL, Arzimanoglou A, Brashear A, Clapcote SJ, Gurrieri F, Goldstein DB et al. Distinct neurological disorders with ATP1A3 mutations. Lancet Neurol 2014; 13: 503–514.

Neville BGR, Ninan M. The treatment and management of alternating hemiplegia of childhood. Dev Med Child Neurol 2007; 49: 777–780.

Child Neurology: Alternating hemiplegia of childhood | Neurology. https://n.neurology.org/content/74/14/e57 (accessed 14 May2019).

Ju J, Hirose S, Shi X-Y, Ishii A, Hu L-Y, Zou L-P. Treatment with Oral ATP decreases alternating hemiplegia of childhood with de novo ATP1A3 Mutation. Orphanet J Rare Dis 2016; 11. doi:10.1186/s13023-016-0438-7.

Excellent response to a ketogenic diet in a patient with alternating hemiplegia of childhood. - PubMed - NCBI. https://www.ncbi.nlm.nih.gov/pubmed/24532324 (accessed 3 May2019).

Ulate-Campos A, Fons C, Artuch R, Castejón E, Martorell L, Ozelius L et al. Alternating hemiplegia of childhood with a de novo mutation in ATP1A3 and changes in SLC2A1 responsive to a ketogenic diet. Pediatr Neurol 2014; 50: 377–379.

A unitary mechanism of calcium antagonist drug action. - PubMed - NCBI. https://www.ncbi.nlm.nih.gov/pubmed/6572372 (accessed 3 May2019).

Published

2021-12-20

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How to Cite

1.
Garbuio GC, Mio JR, Feltrin LC, Silva MS, Carneiro ZA, Lourenço CM. A de novo missense pathogenic mutation c.2415C> G (p.Asp805Glu) in ATP1A3 gene in a patient with alternating hemiplegia of childhood with favorable response to biperiden hydrochloride . Medicina (Ribeirão Preto) [Internet]. 2021 Dec. 20 [cited 2024 Jun. 17];54(3):e-167265. Available from: https://www.periodicos.usp.br/rmrp/article/view/167265