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Progressive myoclonic epilepsy type 6(EPM6)

MedGen UID:
1681379
Concept ID:
C5190805
Disease or Syndrome
Synonyms: EPILEPSY, PROGRESSIVE MYOCLONIC, 6; EPM6
SNOMED CT: Progressive myoclonic epilepsy type 6 (783062001); North Sea progressive myoclonus epilepsy (783062001); Progressive myoclonus epilepsy type 6 (783062001); GOSR2 (golgi SNAP receptor complex member 2) related progressive myoclonus ataxia (783062001); GOSR2-related progressive myoclonus ataxia (783062001); PME (progressive myoclonic epilepsy) type 6 (783062001)
Modes of inheritance:
Autosomal recessive inheritance
MedGen UID:
141025
Concept ID:
C0441748
Intellectual Product
Source: Orphanet
A mode of inheritance that is observed for traits related to a gene encoded on one of the autosomes (i.e., the human chromosomes 1-22) in which a trait manifests in individuals with two pathogenic alleles, either homozygotes (two copies of the same mutant allele) or compound heterozygotes (whereby each copy of a gene has a distinct mutant allele).
 
Gene (location): GOSR2 (17q21.32)
 
Monarch Initiative: MONDO:0013526
OMIM®: 614018
Orphanet: ORPHA280620

Definition

Progressive myoclonic epilepsy-6 (EPM6) is an autosomal recessive neurologic disorder characterized by onset of ataxia in the first years of life, followed by action myoclonus and seizures later in childhood, and loss of independent ambulation in the second decade. Cognition is not usually affected, although mild memory difficulties may occur in the third decade (summary by Corbett et al., 2011). For a discussion of genetic heterogeneity of progressive myoclonic epilepsy, see EPM1A (254800). [from OMIM]

Clinical features

From HPO
Pes cavus
MedGen UID:
675590
Concept ID:
C0728829
Congenital Abnormality
An increase in height of the medial longitudinal arch of the foot that does not flatten on weight bearing (i.e., a distinctly hollow form of the sole of the foot when it is bearing weight).
Cerebellar ataxia
MedGen UID:
849
Concept ID:
C0007758
Disease or Syndrome
Cerebellar ataxia refers to ataxia due to dysfunction of the cerebellum. This causes a variety of elementary neurological deficits including asynergy (lack of coordination between muscles, limbs and joints), dysmetria (lack of ability to judge distances that can lead to under- or overshoot in grasping movements), and dysdiadochokinesia (inability to perform rapid movements requiring antagonizing muscle groups to be switched on and off repeatedly).
Dysarthria
MedGen UID:
8510
Concept ID:
C0013362
Mental or Behavioral Dysfunction
Dysarthric speech is a general description referring to a neurological speech disorder characterized by poor articulation. Depending on the involved neurological structures, dysarthria may be further classified as spastic, flaccid, ataxic, hyperkinetic and hypokinetic, or mixed.
Myoclonus
MedGen UID:
10234
Concept ID:
C0027066
Finding
Very brief, involuntary random muscular contractions occurring at rest, in response to sensory stimuli, or accompanying voluntary movements.
Tremor
MedGen UID:
21635
Concept ID:
C0040822
Sign or Symptom
An unintentional, oscillating to-and-fro muscle movement about a joint axis.
Memory impairment
MedGen UID:
68579
Concept ID:
C0233794
Mental or Behavioral Dysfunction
An impairment of memory as manifested by a reduced ability to remember things such as dates and names, and increased forgetfulness.
Areflexia
MedGen UID:
115943
Concept ID:
C0234146
Finding
Absence of neurologic reflexes such as the knee-jerk reaction.
Atonic seizure
MedGen UID:
78735
Concept ID:
C0270846
Disease or Syndrome
Atonic seizure is a type of motor seizure characterized by a sudden loss or diminution of muscle tone without apparent preceding myoclonic or tonic event lasting about 1 to 2 seconds, involving head, trunk, jaw, or limb musculature.
Bilateral tonic-clonic seizure
MedGen UID:
141670
Concept ID:
C0494475
Sign or Symptom
A bilateral tonic-clonic seizure is a seizure defined by a tonic (bilateral increased tone, lasting seconds to minutes) and then a clonic (bilateral sustained rhythmic jerking) phase.
Gait disturbance
MedGen UID:
107895
Concept ID:
C0575081
Finding
The term gait disturbance can refer to any disruption of the ability to walk.
Loss of ambulation
MedGen UID:
332305
Concept ID:
C1836843
Finding
Inability to walk in a person who previous had the ability to walk.
EEG with spike-wave complexes
MedGen UID:
869259
Concept ID:
C4023683
Finding
Complexes of spikes (<70 ms) and sharp waves (70-200 ms), which are sharp transient waves that have a strong association with epilepsy, in cerebral electrical activity recorded along the scalp by electroencephalography (EEG).
Generalized non-motor (absence) seizure
MedGen UID:
1385688
Concept ID:
C4316903
Disease or Syndrome
A generalized non-motor (absence) seizure is a type of a type of dialeptic seizure that is of electrographically generalized onset. It is a generalized seizure characterized by an interruption of activities, a blank stare, and usually the person will be unresponsive when spoken to. Any ictal motor phenomena are minor in comparison to these non-motor features.
Myoclonic status epilepticus
MedGen UID:
1712171
Concept ID:
C5397681
Disease or Syndrome
A type of motor status epilepticus with repeating bilateral sudden brief (less than 100 ms) involuntary single or multiple contraction of muscles or muscle groups of variable topography.
Scoliosis
MedGen UID:
11348
Concept ID:
C0036439
Disease or Syndrome
The presence of an abnormal lateral curvature of the spine.
Elevated circulating creatine kinase concentration
MedGen UID:
69128
Concept ID:
C0241005
Finding
An elevation of the level of the enzyme creatine kinase (also known as creatine phosphokinase (CK; EC 2.7.3.2) in the blood. CK levels can be elevated in a number of clinical disorders such as myocardial infarction, rhabdomyolysis, and muscular dystrophy.

Term Hierarchy

CClinical test,  RResearch test,  OOMIM,  GGeneReviews,  VClinVar  
  • CROGVProgressive myoclonic epilepsy type 6

Professional guidelines

PubMed

Mir A, Alghamdi A, Alotaibi W, Samreen D, Alotaibi M, Albaradie R, Bashir S
Epileptic Disord 2022 Aug 1;24(4):633-646. doi: 10.1684/epd.2022.1439. PMID: 35770766
Rus CM, Weissensteiner T, Pereira C, Susnea I, Danquah BD, Morales Torres G, Rocha ME, Cozma C, Saravanakumar D, Mannepalli S, Kandaswamy KK, Di Bucchianico S, Zimmermann R, Rolfs A, Bauer P, Beetz C
Orphanet J Rare Dis 2022 May 3;17(1):179. doi: 10.1186/s13023-022-02288-8. PMID: 35505348Free PMC Article

Recent clinical studies

Etiology

Vogt H, Baisch T, Mueller-Pfeiffer C, Mothersill IW
Epileptic Disord 2023 Jun;25(3):297-308. Epub 2023 May 22 doi: 10.1002/epd2.20017. PMID: 37536959
Mir A, Alghamdi A, Alotaibi W, Samreen D, Alotaibi M, Albaradie R, Bashir S
Epileptic Disord 2022 Aug 1;24(4):633-646. doi: 10.1684/epd.2022.1439. PMID: 35770766
Macdonald M, Crawford J, Datta AN
J Child Neurol 2021 Oct;36(11):1027-1033. Epub 2021 Jul 27 doi: 10.1177/08830738211026072. PMID: 34315269
d'Orsi G, Specchio LM; Apulian Study Group on Senile Myoclonic Epilepsy
J Neurol 2014 Aug;261(8):1584-97. Epub 2014 Jun 4 doi: 10.1007/s00415-014-7376-x. PMID: 24893590
Delgado-Escueta AV, Serratosa JM, Liu A, Weissbecker K, Medina MT, Gee M, Treiman LJ, Sparkes RS
Epilepsia 1994;35 Suppl 1:S29-40. doi: 10.1111/j.1528-1157.1994.tb05926.x. PMID: 8293722

Diagnosis

Mir A, Alghamdi A, Alotaibi W, Samreen D, Alotaibi M, Albaradie R, Bashir S
Epileptic Disord 2022 Aug 1;24(4):633-646. doi: 10.1684/epd.2022.1439. PMID: 35770766
d'Orsi G, Specchio LM; Apulian Study Group on Senile Myoclonic Epilepsy
J Neurol 2014 Aug;261(8):1584-97. Epub 2014 Jun 4 doi: 10.1007/s00415-014-7376-x. PMID: 24893590
Valero T
Curr Pharm Des 2014;20(35):5507-9. doi: 10.2174/138161282035140911142118. PMID: 24606795
Kälviäinen R, Khyuppenen J, Koskenkorva P, Eriksson K, Vanninen R, Mervaala E
Epilepsia 2008 Apr;49(4):549-56. Epub 2008 Mar 5 doi: 10.1111/j.1528-1167.2008.01546.x. PMID: 18325013
Lehesjoki AE, Koskiniemi M
Epilepsia 1999;40 Suppl 3:23-8. doi: 10.1111/j.1528-1157.1999.tb00895.x. PMID: 10446747

Therapy

Mir A, Alghamdi A, Alotaibi W, Samreen D, Alotaibi M, Albaradie R, Bashir S
Epileptic Disord 2022 Aug 1;24(4):633-646. doi: 10.1684/epd.2022.1439. PMID: 35770766
Valero T
Curr Pharm Des 2014;20(35):5507-9. doi: 10.2174/138161282035140911142118. PMID: 24606795
Kälviäinen R, Khyuppenen J, Koskenkorva P, Eriksson K, Vanninen R, Mervaala E
Epilepsia 2008 Apr;49(4):549-56. Epub 2008 Mar 5 doi: 10.1111/j.1528-1167.2008.01546.x. PMID: 18325013
Lehesjoki AE, Koskiniemi M
Epilepsia 1999;40 Suppl 3:23-8. doi: 10.1111/j.1528-1157.1999.tb00895.x. PMID: 10446747
Lehesjoki AE, Koskiniemi M
Ann Med 1998 Oct;30(5):474-80. doi: 10.3109/07853899809002489. PMID: 9814834

Prognosis

Macdonald M, Crawford J, Datta AN
J Child Neurol 2021 Oct;36(11):1027-1033. Epub 2021 Jul 27 doi: 10.1177/08830738211026072. PMID: 34315269
d'Orsi G, Specchio LM; Apulian Study Group on Senile Myoclonic Epilepsy
J Neurol 2014 Aug;261(8):1584-97. Epub 2014 Jun 4 doi: 10.1007/s00415-014-7376-x. PMID: 24893590
Valero T
Curr Pharm Des 2014;20(35):5507-9. doi: 10.2174/138161282035140911142118. PMID: 24606795
Kälviäinen R, Khyuppenen J, Koskenkorva P, Eriksson K, Vanninen R, Mervaala E
Epilepsia 2008 Apr;49(4):549-56. Epub 2008 Mar 5 doi: 10.1111/j.1528-1167.2008.01546.x. PMID: 18325013
Lehesjoki AE, Koskiniemi M
Epilepsia 1999;40 Suppl 3:23-8. doi: 10.1111/j.1528-1157.1999.tb00895.x. PMID: 10446747

Clinical prediction guides

Mir A, Alghamdi A, Alotaibi W, Samreen D, Alotaibi M, Albaradie R, Bashir S
Epileptic Disord 2022 Aug 1;24(4):633-646. doi: 10.1684/epd.2022.1439. PMID: 35770766
Macdonald M, Crawford J, Datta AN
J Child Neurol 2021 Oct;36(11):1027-1033. Epub 2021 Jul 27 doi: 10.1177/08830738211026072. PMID: 34315269
Oliver KL, Franceschetti S, Milligan CJ, Muona M, Mandelstam SA, Canafoglia L, Boguszewska-Chachulska AM, Korczyn AD, Bisulli F, Di Bonaventura C, Ragona F, Michelucci R, Ben-Zeev B, Straussberg R, Panzica F, Massano J, Friedman D, Crespel A, Engelsen BA, Andermann F, Andermann E, Spodar K, Lasek-Bal A, Riguzzi P, Pasini E, Tinuper P, Licchetta L, Gardella E, Lindenau M, Wulf A, Møller RS, Benninger F, Afawi Z, Rubboli G, Reid CA, Maljevic S, Lerche H, Lehesjoki AE, Petrou S, Berkovic SF
Ann Neurol 2017 May;81(5):677-689. doi: 10.1002/ana.24929. PMID: 28380698
d'Orsi G, Specchio LM; Apulian Study Group on Senile Myoclonic Epilepsy
J Neurol 2014 Aug;261(8):1584-97. Epub 2014 Jun 4 doi: 10.1007/s00415-014-7376-x. PMID: 24893590
Valero T
Curr Pharm Des 2014;20(35):5507-9. doi: 10.2174/138161282035140911142118. PMID: 24606795

Recent systematic reviews

Mir A, Alghamdi A, Alotaibi W, Samreen D, Alotaibi M, Albaradie R, Bashir S
Epileptic Disord 2022 Aug 1;24(4):633-646. doi: 10.1684/epd.2022.1439. PMID: 35770766
Pondrelli F, Muccioli L, Licchetta L, Mostacci B, Zenesini C, Tinuper P, Vignatelli L, Bisulli F
Orphanet J Rare Dis 2021 Aug 16;16(1):362. doi: 10.1186/s13023-021-01989-w. PMID: 34399803Free PMC Article

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