Table 1 Clinical presentations in patients with the four mutations.

From: Heteromeric Kv7.2 current changes caused by loss-of-function of KCNQ2 mutations are correlated with long-term neurodevelopmental outcomes

Genotype in patients

c.740C > A (S247X)42

c.740C > G (S247W)41

c.740C > T (S247L)

c.853 C > A (P285T)

Pattern of inheritance

Inherited, autosomal dominance

De novo

De novo

De novo

Functional domain

S5

S5

S5

Pore domain

Family history

+ (5 affected family members)

No

No

No

First seizure day

Day 5

Day 3

Day 3

Day 2

Seizure frequency before drug control

+

+++

+++

+++

Antiepileptic drugs

PB

Intravenous PB, PHT, oral pyridoxine, PB, and SAB

Intravenous PB, PHT then oral PB, SAB, CLN

Intravenous PB, PHT then oral PB, SAB, CLN, OXC

Age when seizure-free

6 months

No remission of seizures

Partial remission of seizures at 4 months, with recurrent febrile seizures

Partial remission of seizures at 2 months

Seizure types

Bicycling of legs and arms, apnea

Multifocal with left or right head deviation and upper and lower limb involvement

Generalized tonic

Generalized tonic

Initial EEG

Central sharp waves or spikes

Burst-suppression pattern

Burst-suppression pattern

Burst-suppression pattern

MRI/ CT

Normal

Normal MRI at 18 days and normal third CT scan at 30 days

Basal ganglion

Thin corpus callosum

Neurodevelopmental outcomes

Unremarkable

Poor at 2 year and 5 months: head control and social smiling but inability to sit without support, muscle hypotonia, dystonic features

Poor at 3 years: inability to sit without support, inability to walk, lack of language production, severe cognitive disability

Poor at 2 years and 4 months: inability to sit without support, inability to walk, lack of language production, severe cognitive disability

  1. PHT, phenytoin; OXC, oxcarbazepine; TOP, topiramate; PB, phenobarbital; SAB, vigabatrin; CLN, clonazepam; MRI, magnetic resonance imaging; CT, computed tomography; EEG, electroencephalography; ++ +, daily; ++, weekly; +, less than weekly; ADHD, attention deficit and hyperactivity; Dev. Del./Int. Dis., Developmental delay/intellectual disability. The sequence data of each patient were checked against the GenBank reference sequence and version number of KCNQ2 gene (NM_172107.3).