Neuropediatrics 2022; 53(01): 069-074
DOI: 10.1055/s-0041-1739132
Resident and Fellow Section: Short Communication

Alternating Hemiplegia of Childhood in a Child Harboring a Novel TBC1D24 Mutation: Case Report and Literature Review

Ramona Cordani*
1   Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
,
1   Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
2   Child Neuropsychiatry Unit, ASST Fatebenefratelli- Sacco, Milano, Italy
,
Maria Margherita Mancardi
3   Department of Clinical and Surgical Neurosciences and Rehabilitation, Child Neuropsychiatry Unit, Giannina Gaslini Institute, Genova, Italy
,
Michela Stagnaro
3   Department of Clinical and Surgical Neurosciences and Rehabilitation, Child Neuropsychiatry Unit, Giannina Gaslini Institute, Genova, Italy
,
Giulia Prato
3   Department of Clinical and Surgical Neurosciences and Rehabilitation, Child Neuropsychiatry Unit, Giannina Gaslini Institute, Genova, Italy
,
1   Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
3   Department of Clinical and Surgical Neurosciences and Rehabilitation, Child Neuropsychiatry Unit, Giannina Gaslini Institute, Genova, Italy
,
4   Department of Neurosciences, University of Turin, Turin, Italy
5   Neuroradiology Unit, Giannina Gaslini Institute, Genova, Italy
,
Peter Walsh
6   Department of Neurology, Children's Neuroscience Service, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
,
Twinkle Ghia
6   Department of Neurology, Children's Neuroscience Service, Princess Margaret Hospital for Children, Perth, Western Australia, Australia
,
Lino Nobili
1   Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
3   Department of Clinical and Surgical Neurosciences and Rehabilitation, Child Neuropsychiatry Unit, Giannina Gaslini Institute, Genova, Italy
,
Elisa De Grandis
1   Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health (DINOGMI), University of Genoa, Genoa, Italy
3   Department of Clinical and Surgical Neurosciences and Rehabilitation, Child Neuropsychiatry Unit, Giannina Gaslini Institute, Genova, Italy
› Author Affiliations

Abstract

Alternating Hemiplegia of Childhood (AHC) is a rare neurological disease characterized by early-onset recurrent paroxysmal events and persistent neurological deficits. TBC1D24 gene variants have been associated with a phenotypic spectrum having epilepsy as the main clinical manifestation. Herein, we report the case of a child affected by developmental delay, polymorphic seizures, and nonepileptic episodes characterized by hemiplegia or bilateral plegia, pallor, hypotonia, and dystonic postures without loss of consciousness that resolved with sleep. Noteworthy, the patient fulfills all the diagnostic criteria for AHC. An epilepsy gene panel revealed a novel TBC1D24 mutation. This variant may be considered a PM5, according to the American College of Medical Genetics and Genomics guidelines. TBC1D24 gene variants are associated with various clinical features, and increasing data confirms the association with permanent and paroxysmal movement disorders. Our report suggests that the TBC1D24 molecular analysis could be considered in the diagnostic workup of AHC patients.

* R.C. and L.P. contributed equally to this work.




Publication History

Received: 08 January 2021

Accepted: 15 September 2021

Article published online:
01 December 2021

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  • References

  • 1 Panagiotakaki E, De Grandis E, Stagnaro M. et al; Italian IBAHC Consortium, French AHC Consortium, International AHC Consortium. Clinical profile of patients with ATP1A3 mutations in Alternating Hemiplegia of Childhood-a study of 155 patients. Orphanet J Rare Dis 2015; 10: 123-135
  • 2 Pisciotta L, Gherzi M, Stagnaro M. et al; I.B.AHC Consortium. Alternating hemiplegia of childhood: pharmacological treatment of 30 Italian patients. Brain Dev 2017; 39 (06) 521-528
  • 3 Balestrini S, Milh M, Castiglioni C. et al. TBC1D24 genotype-phenotype correlation: Epilepsies and other neurologic features. Neurology 2016; 87 (01) 77-85
  • 4 Carecchio M, Mencacci NE. Emerging monogenic complex hyperkinetic disorders. Curr Neurol Neurosci Rep 2017; 17 (12) 97
  • 5 Duru N, Iseri SA, Selçuk N, Tolun A. Early-onset progressive myoclonic epilepsy with dystonia mapping to 16pter-p13.3. J Neurogenet 2010; 24 (04) 207-215
  • 6 Guven A, Tolun A. TBC1D24 truncating mutation resulting in severe neurodegeneration. J Med Genet 2013; 50 (03) 199-202
  • 7 Lüthy K, Mei D, Fischer B. et al. TBC1D24-TLDc-related epilepsy exercise-induced dystonia: rescue by antioxidants in a disease model. Brain 2019; 142 (08) 2319-2335
  • 8 Zimmern V, Riant F, Roze E. et al. Infantile-onset paroxysmal movement disorder and episodic ataxia associated with a TBC1D24 mutation. Neuropediatrics 2019; 50 (05) 308-312
  • 9 Zhou Q, Lin Y, Ye J. et al. Homozygous TBC1D24 mutation in a case of epilepsia partialis continua. Front Neurol 2018; 8: 750
  • 10 Ngoh A, Bras J, Guerreiro R. et al. TBC1D24 mutations in a sibship with multifocal polymyoclonus. Tremor Other Hyperkinet Mov (N Y) 2017; 7: 452
  • 11 Ragona F, Castellotti B, Salis B. et al. Alternating hemiplegia and epilepsia partialis continua: a new phenotype for a novel compound TBC1D24 mutation. Seizure 2017; 47: 71-73
  • 12 Neville BG, Ninan M. The treatment and management of alternating hemiplegia of childhood. Dev Med Child Neurol 2007; 49 (10) 777-780
  • 13 Uchitel J, Helseth A, Prange L. et al. The epileptology of alternating hemiplegia of childhood. Neurology 2019; 93 (13) e1248-e1259
  • 14 Bourgeois M, Aicardi J, Goutières F. Alternating hemiplegia of childhood. J Pediatr 1993; 122 (5 Pt 1): 673-679
  • 15 Sasaki M, Ishii A, Saito Y, Hirose S. Progressive brain atrophy in alternating hemiplegia of childhood. Mov Disord Clin Pract (Hoboken) 2017; 4 (03) 406-411
  • 16 Panagiotakaki E, Gobbi G, Neville B. et al; ENRAH Consortium. Evidence of a non-progressive course of alternating hemiplegia of childhood: study of a large cohort of children and adults. Brain 2010; 133 (Pt 12): 3598-3610
  • 17 Sen K, Hicks MA, Huq AHM, Agarwal R. Homozygous TANGO2 single nucleotide variants presenting with additional manifestations resembling alternating hemiplegia of childhood-expanding the phenotype of a recently reported condition. Neuropediatrics 2019; 50 (02) 122-125