Early onset or syndromic epilepsy
Gene: FLNA
I would support this to be a green gene. See gene reviews for FLNA-related periventricular nodular heterotopia https://www.ncbi.nlm.nih.gov/books/NBK1213/
NB: inheritance is X linked, but males usually have prenatal/early lethality, heterozygous females are often affected.Created: 21 Nov 2019, 5:49 p.m. | Last Modified: 21 Nov 2019, 5:49 p.m.
Panel Version: 1.425
Mode of inheritance
X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
I think FLNA is well recognised as a cause of nodular heterotopia and epilepsy.Created: 7 Oct 2019, 2:17 p.m. | Last Modified: 7 Oct 2019, 2:17 p.m.
Panel Version: 1.352
Mode of inheritance
MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted
Many phenotypes - one is periventricular nodular heterotopia (XLD) of which epilepsy is common.Created: 6 Aug 2019, 8:31 p.m. | Last Modified: 6 Aug 2019, 8:31 p.m.
Panel Version: 1.188
Mode of inheritance
X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
Phenotypes
Heterotopia periventricular, 1 300049
Publications
Comment on mode of inheritance: At the Webex call 22nd November 2019, it was noted that want to target FEMALES ONLY for the Heterotopia periventricular phenotype.Created: 25 Nov 2019, 8:38 p.m. | Last Modified: 26 Nov 2019, 4:06 p.m.
Panel Version: 1.474
As discussed with members of the GMS Neurology Specialist Test Group on the Webex call 22nd November 2019 for Clinical Indication R59 Early onset or syndromic epilepsy, and following Green ratings by Alisdair McNeill and Alison Callaway: Agreed that there is enough evidence to rate this gene Green. Kept rating of FLNA as Green.Created: 25 Nov 2019, 8:33 p.m. | Last Modified: 25 Nov 2019, 8:34 p.m.
Panel Version: 1.433
Added a Red review to highlight the comment from Diane Cairns (Manchester University NHS, North West GLH) that it would be acceptable to remove this gene from the Epilepsy Panel.Created: 7 Oct 2019, 9:46 a.m. | Last Modified: 7 Oct 2019, 9:46 a.m.
Panel Version: 1.351
Diane Cairns (Manchester University NHS, North West GLH) comments that "I have looked into the variants that we found on our Epilepsy panel in the FLNA, SCN9A and KCNA1 genes. Using ACGS guidelines these variants are all Class 3 or below, we therefore feel that it would be acceptable to remove these genes from the Epilepsy Panel." (personal communication via email to Jane Deller, 2019-09-04)Created: 5 Sep 2019, 2:52 p.m. | Last Modified: 5 Sep 2019, 2:52 p.m.
Panel Version: 1.262
As discussed with members of the GMS Neurology Specialist Test Group on the Webex call Thursday 8th August 2019 for Clinical Indication R59 Early onset or syndromic epilepsy: Agreed that there is sufficient evidence to rate this gene Green. Kept rating as Green.Created: 15 Aug 2019, 10:07 a.m. | Last Modified: 15 Aug 2019, 10:07 a.m.
Panel Version: 1.230
Review and rating collated by Tracy Lester (Oxford Medical Genetics Laboratories Oxford University Hospitals NHS Foundation Trust, 2019_02_06) on behalf of Wessex and West Midlands GLH for GMS Neurology specialist test group, for Clinical Indication R59 'Early onset or syndromic epilepsy'. Review contributors: John Taylor and Helen Lord. Suggested gene rating: Amber.Created: 6 Aug 2019, 8:38 p.m. | Last Modified: 6 Aug 2019, 8:38 p.m.
Panel Version: 1.189
PMID:25755106. In a woman and her 3 daughters with a complex phenotype comprising both periventricular nodular heterotopia and Melnick-Needles syndrome, Parrini et al. (2015) identified a c.622G-C transversion in exon 3 of the FLNA gene (G208R). The 3 daughters had onset of seizures in the first decade.Created: 22 Jul 2019, 12:36 p.m. | Last Modified: 22 Jul 2019, 12:36 p.m.
Panel Version: 1.174
PMID:20014127. In an 18-month-old girl with periventricular nodular heterotopia and seizures, Jefferies et al. (2010) identified a heterozygous 7896G-A transition in the FLNA gene (W2632X).Created: 22 Jul 2019, 12:36 p.m. | Last Modified: 22 Jul 2019, 12:36 p.m.
Panel Version: 1.174
PMID:15668422. Sheen et al., 2005 report three females with FLNA variants and periventricular heterotopia. One of the females (F8) had seizures and a 116C>G (p.A39G) variant in FLNA.Created: 22 Jul 2019, 12:36 p.m. | Last Modified: 22 Jul 2019, 12:36 p.m.
Panel Version: 1.174
Comment when marking as ready: Associated with relevant phenotype in OMIM and as confirmed Gen2Phen gene. At least 16 variants reported Heterotopia, periventricular 300049. One case of Intestinal pseudoobstruction, neuronal 300048 had seizures at different stages of life from infancy (PMID 17357080), report of de novo epileptic encephalopathy (PMID 23934111).Created: 3 Sep 2018, 2:27 p.m.
XLD; but note affected males have also been described, sometimes with ID/features of frontonasal dysplasia.
Seizures are part of the phenotype.Created: 13 Aug 2018, 11:30 p.m.
Mode of inheritance
Other
Phenotypes
Heterotopia, periventricular, MIM#300049
Variants in this GENE are reported as part of current diagnostic practice
Phenotypes for gene: FLNA were changed from Heterotopia, periventricular 300049 to Heterotopia, periventricular OMIM:300049
Mode of inheritance for gene: FLNA was changed from X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males) to X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
Source North West GLH was added to FLNA.
Gene: flna has been classified as Green List (High Evidence).
Source Wessex and West Midlands GLH was added to FLNA.
Source NHS GMS was added to FLNA.
Publications for gene: FLNA were set to 15668422; 20014127; 25755106
Publications for gene: FLNA were set to
Zornitza Stark: XLD; but note affected males h
Gene: flna has been classified as Green List (High Evidence).
Phenotypes for gene: FLNA were set to Heterotopia, periventricular 300049
Mode of inheritance for gene: FLNA was changed from to X-LINKED: hemizygous mutation in males, monoallelic mutations in females may cause disease (may be less severe, later onset than males)
Gene: flna has been classified as Green List (High Evidence).
Expert Review Amber was added to FLNA. Panel: Genetic Epilepsy Syndromes
FLNA was added to Genetic Epilepsy Syndromes panel. Sources: Victorian Clinical Genetics Services
FLNA was created by Sarah Leigh