Neuropediatrics 2018; 49(S 02): S1-S69
DOI: 10.1055/s-0038-1676009
Posters
Neurogenetics
Georg Thieme Verlag KG Stuttgart · New York

P 1162. Somatic Mosaics in Epileptogenic Tissue—Background and Therapeutic Implications of Molecular Changes in Structural Epilepsies

Jan Henje Döring
1   Zentrum für Kinder- und Jugendmedizin, Sektion für Neuropädiatrie und Stoffwechselmedizin, Heidelberg, Germany
,
Julia Jacobs-Le Van
2   Universitätsklinikum Freiburg, Epilepsiezentrum Freiburg, Sektion für Epilepsiediagnostikim Kindes- und Jugendalter, Freiburg, Germany
,
Thomas Bast
3   Epilepsiezentrum Kork, Kehl, Germany
,
Georg Friedrich Hoffmann
1   Zentrum für Kinder- und Jugendmedizin, Sektion für Neuropädiatrie und Stoffwechselmedizin, Heidelberg, Germany
,
Stefan Kölker
1   Zentrum für Kinder- und Jugendmedizin, Sektion für Neuropädiatrie und Stoffwechselmedizin, Heidelberg, Germany
,
Catharina Donkels
5   Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Experimental Epilepsy Research, Freiburg, Germany
,
Johannes Lemke
4   Institut für Humangenetik Universitätsklinikum Leipzig, Leipzig, Germany
,
Carola A. Haas
5   Universitätsklinikum Freiburg, Klinik für Neurochirurgie, Experimental Epilepsy Research, Freiburg, Germany
,
David Jones
6   Deutsches Krebsforschungszentrum, Heidelberg, Germany
,
Stefan Pfister
7   Universitätsklinikum Heidelberg, Zentrum für Kinder- und Jugendmedizin, Klinik Kinderheilkunde III, Heidelberg, Germany
,
Steffen Syrbe
1   Zentrum für Kinder- und Jugendmedizin, Sektion für Neuropädiatrie und Stoffwechselmedizin, Heidelberg, Germany
› Author Affiliations
Further Information

Publication History

Publication Date:
30 October 2018 (online)

 

Background: Recently, a large number of monogenic causes of genetic epileptic encephalopathies have been identified by high-throughput sequencing. Nevertheless, in up to 70% of cases, a suspected genetic cause cannot be identified. Somatic mosaicism in epileptogenic lesions (such as focal cortical dysplasia, hemimegalencephaly, polymicrogyria) may explain some of these epilepsies.

Objectives: Analogous to the molecular genetic characterization of central nervous system (CNS) tumors, the planned study should lead to an extension of the diagnostic work-up of epileptogenic lesions and hereby to new therapeutic consequences.

Procedure:

1. Build a database on children who have undergone epileptic surgery in recent years.

2. Phenotyping of epilepsies and epileptogenic brain lesions.

3. Database analysis of prior knowledge in the field of somatic genetic alterations in epilepsy. Comparison with experiences in the field of brain tumor research and therapy.

4. Identification of lesions with therapeutic implications (genetic alterations as “drug target”) and presentation of possible therapeutic approaches.

Methods: Description of the cohort of pediatric epilepsy patients who have undergone epilepsy surgery. Identification of existing tissue samples and prioritization for epileptogenic lesions. Literature research for “drug-targetable” genetic alterations. Transfer of prior knowledge of oncological therapies in CNS tumors.

Results: In the past 10 years, 91 pediatric patients of the Heidelberg Epilepsy Center had epilepsy surgery. The epileptogenic lesions are characterized and a diagnostic pathway for the molecular genetic characterization of tissue is presented. “Drug-targetable” lesions and potential pharmacological agents are presented together with analogous developments in tumor biology.

Conclusion: The planned study as well as the results of the literature research show possibilities for improvement in diagnostics, classification, and, in the long term, also therapy of epileptogenic lesions and associated epileptic encephalopathies and developmental disorders.