3例SETD1B基因相关癫痫伴智力障碍患儿临床特点并文献复习

李盈, 潘邹, 郑卓, 朱飒英, 龚强, 尹飞, 彭镜, 陈晨

中国当代儿科杂志 ›› 2025, Vol. 27 ›› Issue (5) : 574-579.

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中国当代儿科杂志 ›› 2025, Vol. 27 ›› Issue (5) : 574-579. DOI: 10.7499/j.issn.1008-8830.2501109
论著·临床研究

3例SETD1B基因相关癫痫伴智力障碍患儿临床特点并文献复习

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Clinical characteristics of epilepsy with intellectual disability associated with SETD1B gene in three pediatric cases and a literature review

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摘要

目的 总结SETD1B基因变异所致癫痫伴智力障碍患儿的临床及遗传学特点。 方法 回顾性分析在中南大学湘雅医院儿童神经专科诊治的3例SETD1B基因变异患儿的临床资料,并复习国内外相关文献,总结该病的临床特点。 结果 3例患儿均婴幼儿期起病,表现为轻度智力障碍及肌阵挛发作,2例有眼睑肌阵挛发作。经3种及以上抗癫痫发作药物治疗后,2例癫痫控制或部分控制,1例为难治性癫痫。3例患儿分别检出SETD1B基因杂合变异(缺失、移码、错义各1例)。现已报道SETD1B基因变异患者54例,共携带56个变异,以错义变异多见(64%,36/56),主要表现为不同程度的发育落后(96%,52/54)及癫痫发作(81%,44/54),并且在44例癫痫发作的患者中常见失神发作(34%,15/44)及肌阵挛(20%,9/44),眼睑肌阵挛发作共报道6例,约五分之一的患者癫痫发作难控制。 结论 SETD1B基因变异所致主要表型为智力障碍及癫痫发作,癫痫发作有一定特点,眼睑肌阵挛发作不罕见。

Abstract

Objective To summarize the clinical and genetic characteristics of epilepsy with intellectual disability caused by SETD1B gene variants in children. Methods A retrospective analysis was conducted on the clinical data of three children with SETD1B gene variants diagnosed and treated at the Department of Pediatric Neurology of Xiangya Hospital of Central South University. Relevant literature was reviewed to summarize the clinical characteristics of this condition. Results All three children presented with symptoms during infancy or early childhood, including mild intellectual disability and myoclonic seizures, with two cases exhibiting eyelid myoclonia. After treatment with three or more antiepileptic drugs, two cases achieved seizure control or partial control, while one case remained refractory. Each of the three children was found to have a heterozygous variant in the SETD1B gene (one deletion, one frameshift, and one missense variant). To date, 54 cases with SETD1B gene variants have been reported, involving a total of 56 variants, predominantly missense variants (64%, 36/56). The main clinical manifestations included varying degrees of developmental delay (96%, 52/54) and seizures (81%, 44/54). Among the 44 patients with seizures, myoclonic (20%, 9/44) and absence seizures (34%, 15/44) were common, with eyelid myoclonia reported in six cases. Approximately one-fifth of these patients had poorly controlled seizures. Conclusions The primary phenotypes associated with SETD1B gene variants are intellectual disability and seizures, and seizures exhibit distinct characteristics. Eyelid myoclonia is not uncommon.

关键词

癫痫 / 眼睑肌阵挛发作 / 全面发育落后 / 智力障碍 / SETD1B / 儿童

Key words

Epilepsy / Eyelid myoclonia / Global developmental delay / Intellectual disability / SETD1B / Child

引用本文

导出引用
李盈, 潘邹, 郑卓, . 3例SETD1B基因相关癫痫伴智力障碍患儿临床特点并文献复习[J]. 中国当代儿科杂志. 2025, 27(5): 574-579 https://doi.org/10.7499/j.issn.1008-8830.2501109
Ying LI, Zou PAN, Zhuo ZHENG, et al. Clinical characteristics of epilepsy with intellectual disability associated with SETD1B gene in three pediatric cases and a literature review[J]. Chinese Journal of Contemporary Pediatrics. 2025, 27(5): 574-579 https://doi.org/10.7499/j.issn.1008-8830.2501109

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作者贡献声明

李盈设计并实施研究、起草文章;郑卓协助采集临床数据;朱飒英协助采集脑电图数据;潘邹、龚强负责分析、解释遗传学数据;尹飞、彭镜对文章的知识性内容作批评性审阅;陈晨对文章的知识性内容作批评性审阅,指导研究、文章撰写。

基金

中国抗癫痫协会“新锐酮学”研究项目基金(CX-A-2021-17)

编委: 王颖

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