Case Report
Copyright ©The Author(s) 2018. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Clin Cases. Oct 26, 2018; 6(12): 570-576
Published online Oct 26, 2018. doi: 10.12998/wjcc.v6.i12.570
CNKSR2 mutation causes the X-linked epilepsy-aphasia syndrome: A case report and review of literature
Ying Sun, Yi-Dan Liu, Zhi-Feng Xu, Qing-Xia Kong, Yan-Ling Wang
Ying Sun, Yi-Dan Liu, Cheeloo College of Medicine, Shandong University, Jinan 250012, Shandong Province, China
Zhi-Feng Xu, First Hospital of Handan, Handan 056002, Hebei Province, China
Qing-Xia Kong, Yan-Ling Wang, Department of Neurology, Affiliated Hospital of Jining Medical University, Jining 272000, Shandong Province, China
Author contributions: Kong QX and Wang YL designed the study and wrote the manuscript; Sun Y, Liu YD and Xu ZF collected the clinical data and edited the manuscript.
Supported by Jining Medical University, No. JYP201740.
Informed consent statement: The patient involved in this study gave his written informed consent authorizing use and disclosure of his protected health information.
Conflict-of-interest statement: All authors have declared no competing interests exist.
Open-Access: This article is an open-access article which was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution Non Commercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: http://creativecommons.org/licenses/by-nc/4.0/
Correspondence to: Qing-Xia Kong, MD, PhD, Chief Doctor, Department of Neurology, Affiliated Hospital of Jining Medical University, Guhuai Road No. 89, Jining 272000, Shandong Province, China. kxdqy8@sohu.com
Telephone: +86-18678766805 Fax: +86-537-2213030
Received: July 2, 2018
Peer-review started: July 2, 2018
First decision: July 29, 2018
Revised: August 21, 2018
Accepted: August 28, 2018
Article in press: August 28, 2018
Published online: October 26, 2018
Processing time: 116 Days and 23.4 Hours
ARTICLE HIGHLIGHTS
Case characteristics

Before experiencing seizures, our patient suffered from developmental delays and attention deficit hyperactivity disorder, which is consistent with the performance of X-linked intellectual disability. After seizure occurrence, the patients’ speech expression gradually decreased, the electroencephalogram (EEG) continued to show abnormal wave patterns during sleep, and a de novo mutation of the CNKSR2 gene was identified.

Clinical diagnosis

X-linked epilepsy-aphasia syndrome.

Differential diagnosis

Hysteria and childhood autism.

Laboratory diagnosis

A de novo mutation of the CNKSR2 gene.

Imaging diagnosis

EEG continued to show abnormal wave patterns during sleep.

Treatment

Immunoglobulin, oral prednisone, lamotrigine and sodium valproate oral solution.

Related reports

Frequency of CNKSR2 mutation in the X-linked epilepsy-aphasia spectrum has been reported in the journal of Epilepsia.

Term explanation

Epileptic encephalopathy with continuous spike-and-wave during sleep.

Experiences and lessons

This case will contribute to improvements in our understanding of X-linked epilepsy-aphasia syndrome. Patients with epilepsy and speech disorders should be advised to undergo EEG monitoring and genetic testing to confirm the diagnosis. The early diagnosis and early use of antiepileptic drugs as well as hormone therapy can recover speech comprehension to different degrees and improve abnormal discharge.