Abstract
Genetic mechanisms explain the pathophysiology of many forms of epilepsy and other
paroxysmal disorders, such as alternating hemiplegia of childhood, familial hemiplegic
migraine, and paroxysmal dyskinesias. Epilepsy is a key feature of well-defined genetic
syndromes including tuberous sclerosis complex, Rett syndrome, Angelman syndrome,
and others. There is an increasing number of single-gene causes or susceptibility
factors associated with several epilepsy syndromes, including the early-onset epileptic
encephalopathies, benign neonatal/infantile seizures, progressive myoclonus epilepsies,
genetic generalized and benign focal epilepsies, epileptic aphasias, and familial
focal epilepsies. Molecular mechanisms are diverse, and a single gene can be associated
with a broad range of phenotypes. Additional features, such as dysmorphisms, head
size, movement disorders, and family history may provide clues to a genetic diagnosis.
Genetic testing can impact medical care and counseling. We discuss genetic mechanisms
of epilepsy and other paroxysmal disorders, tools and indications for genetic testing,
known genotype-phenotype associations, the importance of genetic counseling, and a
look toward the future of epilepsy genetics.
Keywords
genetics - copy number variants - chromosomal microarray - early-onset epileptic encephalopathies
- progressive myoclonus epilepsies