Epilepsy in Angelman syndrome and the most common electroencephalographic findings
*Correspondencia: Dra. Alejandra Sánchez Aparicio. Servicio de Neurofisiología Clínica. Hospital Universitario Puerta de Hierro-Majadahonda. C/ Joaquín Rodrigo, 1. E-28222 Majadahonda, Madrid. E-mail: alejandra.sanchez.aparicio@hotmail.com
Introduction: Angelman syndrome is a genetic disorder characterised by severe mental retardation, subtle dysmorphic facial features, a characteristic behavioural phenotype, seizures and abnormalities in video electroencephalograms (video EEG). Angelman syndrome may be associated with genetic mechanisms involving the region of chromosome 15q11-13. Up to 90% of cases have epileptic seizures, usually in the early years of life. Videoelectroencephalography patterns with some typical characteristics associated with Angelman syndrome have been reported, although these are not specific to it, and as such it is also useful for early diagnosis, especially in the first months or years of life.
Objective: To characterise the videoelectroencephalography findings of 17 patients diagnosed with Angelman syndrome, and compare them with previously published studies.
Patients and methods: We conducted a retrospective observational study of 34 video EEGs performed on 17 patients diagnosed with Angelman syndrome at the clinical neurophysiology service of the Puerta de Hierro University Hospital in Madrid between 2019 and 2022. The primary objective was to characterise the videoelectroencephalographic findings and compare them with previously published studies. As secondary objectives, we analysed the patterns proposed by Dan and Boyd, and other demographic, genetic and clinical data.
Results: Video EEG supported the clinical suspicion in our study, as baseline brain activity was altered in all the patients. We identified a pattern similar to those defined by Dan and Boyd in 88% of the cases, and the type III pattern was the most common in our series.
Conclusions: These findings confirm that video EEG is highly sensitive for the diagnosis of Angelman syndrome, and very useful as a diagnostic biomarker in the early stages of life.
Objetivo Caracterizar los hallazgos videoelectroencefalográficos de 17 pacientes diagnosticados de síndrome de Angelman y compararlos con estudios publicados previamente.
Pacientes y métodos Hemos realizado un estudio observacional retrospectivo de 34 video-EEG, realizados entre 2019 y 2022, de 17 pacientes con diagnóstico de síndrome de Angelman, llevados a cabo en el servicio de neurofisiología clínica del Hospital Universitario Puerta de Hierro. El objetivo principal fue caracterizar los hallazgos videoelectroencefalográficos y compararlos con estudios publicados previamente. Como objetivos secundarios, hemos analizado los patrones propuestos por Dan y Boyd, y otros datos demográficos, genéticos y clínicos.
Resultados El video-EEG apoyó la sospecha clínica en nuestro estudio, dado que la actividad cerebral de base se encontraba alterada en todos los pacientes. En el 88% de los casos fue posible identificar un patrón semejante a los definidos por Dan y Boyd, y, en nuestra serie, el patrón de tipo III fue el más frecuente.
Conclusiones Estos hallazgos confirman la alta sensibilidad del video-EEG para el diagnóstico de síndrome de Angelman y su gran utilidad como biomarcador diagnóstico en la primera etapa de la vida.