Abstract

Investigators at University Hospital, Zurich, Switzerland, and multiple centers in Europe and Canada, sequenced the pyridoxal 5-phosphate oxidase (PNPO) gene in 31 patients with pyridoxine-responsive seizures but normal biomarkers for antiquitin deficiency and normal sequencing of the ALDH7A1 gene.

Highlights

  • Investigators at University Hospital, Zurich, Switzerland, and multiple centers in Europe and Canada, sequenced the pyridoxal 5-phosphate oxidase (PNPO) gene in 31 patients with pyridoxine-responsive seizures but normal biomarkers for antiquitin deficiency and normal sequencing of the ALDH7A1 gene

  • Testing for PNPO mutations is important in pyridoxine-responsive patients with normal biomarkers for antiquitin deficiency or other B6-dependent neonatal epilepsies

  • The challenge of recognizing a delayed pyridoxine effect and lack of specific biomarkers caries a risk of misdiagnosis

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Summary

Introduction

Investigators at University Hospital, Zurich, Switzerland, and multiple centers in Europe and Canada, sequenced the pyridoxal 5-phosphate oxidase (PNPO) gene in 31 patients with pyridoxine-responsive seizures but normal biomarkers for antiquitin deficiency and normal sequencing of the ALDH7A1 gene. Eleven patients from 7 families carried 3 novel mutations of the PNPO gene. Response to pyridoxine was prompt in 4 patients, delayed in 2, on EEG only in 2, and initially absent in another 2 patients. Earlier and continuous pyridoxine therapy was related to a better prognosis.

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Conclusion
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