Abstract |
Neuronal ceroid lipofuscinoses type 2 disease (CLN2) is a very rare, autosomal recessive neurodegerative disease caused by deficient activity of the enzyme tripeptidyl peptidase 1 (TPP1). The seizures in CLN2 are polymorphic and resistant to antiepileptic drugs. In particular, myoclonus (epileptic and non-epileptic) predominant as the disease progresses. Herein, we present a child of CLN2 disease, who had near-continuous myoclonus, and was subsequently attenuated by administration of Perampanel. This girl had initially presented with language delay and generalized tonic clonic seizure at 3 years of age. The diagnosis of CLN2 was made via genetic study, which showed compound heterozygous mutation on TPP1 gene (c.622 C > T and partial gene deletion including at least exons 1-3). Currently, at the age of 8 years, there was near-continuous myoclonus (epileptic and non-epileptic), which worsen during acute illness. Eventually, she was given Perampanel with starting dose of 1 mg/day and slowly titrated upto 6 mg/day in 4 weeks. There was significant attenuation of myoclonus (>50% seizure reduction). To our knowledge, this is the first case in the literature describing the efficacy of perampanel in treating myoclonus in CLN2 disease.
|
Authors | Lee Chin Wong, Chia-Jui Hsu, Wang-Tso Lee |
Journal | Brain & development
(Brain Dev)
Vol. 41
Issue 9
Pg. 817-819
(Oct 2019)
ISSN: 1872-7131 [Electronic] Netherlands |
PMID | 31122803
(Publication Type: Case Reports, Journal Article)
|
Copyright | Copyright © 2019 The Japanese Society of Child Neurology. Published by Elsevier B.V. All rights reserved. |
Chemical References |
- Anticonvulsants
- Nitriles
- Pyridones
- Tripeptidyl-Peptidase 1
- Serine Proteases
- Aminopeptidases
- Dipeptidyl-Peptidases and Tripeptidyl-Peptidases
- TPP1 protein, human
- perampanel
|
Topics |
- Aminopeptidases
(genetics)
- Anticonvulsants
(therapeutic use)
- Child
- Dipeptidyl-Peptidases and Tripeptidyl-Peptidases
(genetics)
- Female
- Humans
- Mutation
- Myoclonus
(diagnostic imaging, drug therapy, genetics, physiopathology)
- Neuronal Ceroid-Lipofuscinoses
(diagnostic imaging, drug therapy, genetics, physiopathology)
- Nitriles
- Pyridones
(therapeutic use)
- Serine Proteases
(genetics)
- Tripeptidyl-Peptidase 1
|