Rare Epilepsy Syndromes and the Congenital Disorders of Glycosylation

Rare Epilepsy Syndromes. Motivated by a recent paper in JIMD Reports, I wanted to use this post to present a very rare group of disorders, in which glycosylation of a variety of tissue proteins and/or lipids is deficient. These so-called congenital disorders of glycosylation (CDG) are a highly heterogeneous group of recessive disorders that you might be confronted with. As CDG may masquerade as otherwise non-specific epileptic encephalopathies, you might encounter them clinically or by browsing through exomes of patients with RES. Imtiaz and colleagues now report on two brothers in a large Saudi family with 18 affected siblings. They identified a mutation in DPAGT1, which is known to cause CDG Ij.   Continue reading

Recessive mutations in autism – the return of hidden metabolic disorders

My wrong guesses of 2012. Two weeks ago during a presentation, I had to admit that there is little evidence for a large contribution of recessive or compound heterozygous mutations in epileptic encephalopathies. At the beginning of 2012, I had initially suggested that recessive or compound heterozygous mutation of known neurometabolic disorders could be identified through exome sequencing in sporadic epileptic encephalopathies. However, as of 2013, there is little evidence for this in our data or the data from other consortia. Now, two papers in Cell suggest a significant contribution of recessive mutations in autism including a revival of the “hidden neurometabolic hypothesis”. Continue reading