Genes in panel

Ataxia and cerebellar anomalies - narrow panel

Gene: SCN2A

Green List (high evidence)

SCN2A (sodium voltage-gated channel alpha subunit 2)
EnsemblGeneIds (GRCh38): ENSG00000136531
EnsemblGeneIds (GRCh37): ENSG00000136531
OMIM: 182390, Gene2Phenotype
SCN2A is in 9 panels

3 reviews

Eleanor Williams (Genomics England Curator)

Green List (high evidence)

The rating of this gene has been updated to green following NHS Genomic Medicine Service approval.
Created: 11 Oct 2023, 10:01 a.m. | Last Modified: 11 Oct 2023, 10:01 a.m.
Panel Version: 4.37

Mode of inheritance
MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted

Achchuthan Shanmugasundram (Genomics England Curator)

Green List (high evidence)

Comment on classification of this gene: The rating for this gene should be GREEN, as this gene has been implicated in ataxia, as identified from monoallelic variants from >20 unrelated individuals/ families from >10 different studies and supported by bioinformatic predictions and electrophysiological and immunohistochemical analyses. The functional studies reveal that at least some of these variants lead to gain-of-function.

A boy identified with de novo heterozygous missense variant (c.788C>T/ p.Ala263Val) in SCN2A gene was reported with neonatal-onset seizures and variable episodes of ataxia, myoclonia, headache, and back pain after 18 months of age. In addition, this variant led to gain-of-function, particularly with increased sodium current and increasing expression of NaV1.2 in granule cell axons projecting to Purkinje neurons (PMID:20956790).

Out of 12 patients reported in another study, one girl (patient 9) identified with de novo heterozygous variant (c.2783T>G/ p.Phe928Cys) was reported with ataxia since 6 weeks of age, while another unrelated girl (c.718G>T/ p.Ala240Ser) had early handedness and episodic breath-holding since 10 days of birth (PMID:26291284).

Three unrelated patients (patient 1: c.5644C>G/ p.Arg1882Gly (de novo); patient 2: c.4565G>C/ p.Gly1522Ala (inherited) & c.5644C>G/ p.Arg1882Gly (de novo); patient 3: c.788C>T/ p.Ala263Val (de novo)) had episodic ataxia 9 and they were reported with seizures in first weeks of life and these patients developed slurred speech, impaired balance, dizziness, headache and episodic ataxia between 15 months and four years of age. In addition, functional studies revealed differential gain-of-function effects for p.Arg1882Gly variant alone or in combination with p.Gly1522Ala (PMID:26645390). c.788C>T/ p.Ala263Val variant was identified with similar clinical history in a 19-month old girl (PMID:27159988) and a three year old boy (PMID:28065826).

Two candidate rare missense variants were identified in a five year old boy, one each in KCNQ3 (p.Arg780His) and SCN2A (p.Gly1634Asp) and was reported with cerebellar atrophy, hypotonia, autism and global developmental delay at age 4 years in addition to episodic ataxia (PMID:27328862).

A mother and her two sons with c.4949T>C (p.Leu1650Pro) variant had episodic ataxia, the mother and the older son had delayed speech development and mildly impaired cognitive development, the older son had mild motor delay and none of them had seizures (PMID:30165711). Similarly, the same variant was identified in a 15-month old boy with episodic ataxia and he inherited this variant from his symptomatic father with episodic hemiplegia (PMID:32893078).

A 38 year old woman born to nonconsanguineous parents that began to manifest psychotic symptoms at 36 years of age was diagnosed with atypical seizure disorder and episodic ataxia in childhood (PMID:30741786). In another report, a Chinese patient and her maternal half-sister, mother and uncle were identified with a novel heterozygous missense variant (c.4820T>C/ p.Val1607Ala). This variant was absent in 100 Chinese health controls and was predicted to be found at the extremely conserved position in mammals. Both the male patient and his elder maternal half-sister suffered from myoclonus and the patient suffered with progressive ataxia (PMID:30813219).

Schwarz et al reported 21 patients with SCN2A-associated episodic ataxia in a more recent study, of which 9 are unpublished cases. A large majority of these patients presented with epileptic seizures, often starting within three months of life. However, the onset of episodic ataxia ranged from ten months to fourteen years of age. In addition to already identified variants including two hotspots (p.Ala263Val variant and variants that affects the S4 segment and its cytoplasmic loop within the domain IV), 6 novel pathogenic variants were identified in this study (PMID:30928199).

The association of SCN2A to Episodic ataxia, type 9 has been documented in OMIM.
Created: 11 Dec 2022, 8:17 a.m. | Last Modified: 11 Dec 2022, 8:17 a.m.
Panel Version: 3.5

Mode of inheritance
MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted

Phenotypes
Episodic ataxia, type 9, MIM# 618924, MONDO:0030064; Developmental and epileptic encephalopathy 11, MIM# 613721, MONDO:0013388

Publications

Mode of pathogenicity
Loss-of-function variants (as defined in pop up message) DO NOT cause this phenotype - please provide details in the comments

Zornitza Stark (Australian Genomics)

Green List (high evidence)

Classically presents with seizures and DD/ID although a range of other manifestations reported, including movement abnormalities, including ataxia, especially episodic ataxia.
Sources: Expert list
Created: 12 Sep 2020, 7:52 a.m.

Mode of inheritance
MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted

Phenotypes
Epileptic encephalopathy, early infantile, 11, MIM# 613721

Publications

Variants in this GENE are reported as part of current diagnostic practice

Details

Mode of Inheritance
MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted
Sources
  • NHS GMS
  • Expert Review Green
Phenotypes
  • Episodic ataxia, type 9, MIM# 618924, MONDO:0030064
  • Developmental and epileptic encephalopathy 11, MIM# 613721, MONDO:0013388
OMIM
182390
Clinvar variants
Variants in SCN2A
Penetrance
None
Publications
Mode of Pathogenicity
Loss-of-function variants (as defined in pop up message) DO NOT cause this phenotype - please provide details in the comments
Panels with this gene

History Filter Activity

11 Oct 2023, Gel status: 3

Removed Tag

Achchuthan Shanmugasundram (Genomics England Curator)

Tag Q4_22_promote_green was removed from gene: SCN2A.

11 Oct 2023, Gel status: 3

Added New Source, Added New Source, Status Update

Achchuthan Shanmugasundram (Genomics England Curator)

Source Expert Review Green was added to SCN2A. Source NHS GMS was added to SCN2A. Rating Changed from Amber List (moderate evidence) to Green List (high evidence)

11 Dec 2022, Gel status: 2

Added Tag

Achchuthan Shanmugasundram (Genomics England Curator)

Tag Q4_22_promote_green tag was added to gene: SCN2A.

11 Dec 2022, Gel status: 2

Set Phenotypes

Achchuthan Shanmugasundram (Genomics England Curator)

Phenotypes for gene: SCN2A were changed from Epileptic encephalopathy, early infantile, 11, MIM# 613721 to Episodic ataxia, type 9, MIM# 618924, MONDO:0030064; Developmental and epileptic encephalopathy 11, MIM# 613721, MONDO:0013388

11 Dec 2022, Gel status: 2

Set publications

Achchuthan Shanmugasundram (Genomics England Curator)

Publications for gene: SCN2A were set to 31924505; 32893078; 31904126

11 Dec 2022, Gel status: 2

Set mode of pathogenicity

Achchuthan Shanmugasundram (Genomics England Curator)

Mode of pathogenicity for gene: SCN2A was changed from None to Loss-of-function variants (as defined in pop up message) DO NOT cause this phenotype - please provide details in the comments

11 Dec 2022, Gel status: 2

Entity classified by Genomics England curator

Achchuthan Shanmugasundram (Genomics England Curator)

Gene: scn2a has been classified as Amber List (Moderate Evidence).

12 Sep 2020, Gel status: 0

Created, Added New Source, Set mode of inheritance, Set publications, Set Phenotypes

Zornitza Stark (Australian Genomics)

gene: SCN2A was added gene: SCN2A was added to Ataxia and cerebellar anomalies - narrow panel. Sources: Expert list Mode of inheritance for gene: SCN2A was set to MONOALLELIC, autosomal or pseudoautosomal, NOT imprinted Publications for gene: SCN2A were set to 31924505; 32893078; 31904126 Phenotypes for gene: SCN2A were set to Epileptic encephalopathy, early infantile, 11, MIM# 613721 Review for gene: SCN2A was set to GREEN gene: SCN2A was marked as current diagnostic