Recent study has shown that mutations in the alpha-II-
spectrin (SPTAN1) gene cause early onset intractable
seizures, severe developmental delay, diffuse hypomyelination, and widespread brain
atrophy. We report a Slovene girl with
hypotonia, lack of visual attention, early onset epileptic
encephalopathy, and severe developmental delay. The patient presented with segmental
myoclonic jerks at the age of 6 weeks, and
infantile spasms at the age of 3.5 months. Her
seizures were resistant to treatment. Multiple electroencephalography recordings showed deterioration of the background activity, followed by multifocal abnormalities before progressing to
hypsarrhythmia. Ophthalmologic examination revealed bilateral dysplastic,
coloboma-like optic discs. Brain magnetic resonance imaging showed diffusely reduced white matter and brainstem volumes with hypomyelination. A de novo heterozygous in-frame deletion was detected in SPTAN1: c.6619_6621delGAG (p.E2270del). This report supports the causative relationship between SPTAN1 mutations and early onset intractable
seizures with severe hypomyelination and widespread brain volume reduction.
Coloboma-like optic discs might be an additional feature observed in patients with SPTAN1 mutations.