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Biomedical subjects

S L Kugler

Publications and source records attributed to S L Kugler.

8 recordsLinked to original sources

Hereditary febrile seizures: phenotype and evidence for a chromosome 19p locus.

The occurrence of febrile seizures (FSs) in large autosomal dominant FS kindreds makes possible accurate delineation of the pure clinical phenotype of hereditary FS among secondary FS cases, and the identification of gene loci causing susceptibility to FS. Recently FS gene loci on chromosomes 8 and 19 were identified. We studied the phenotype of FS in four large families in which FS is an autosomal dominant trait. Among 30 affected secondary FS cases, mean age of onset was 16.3 months (range 4 to 36 months), sex ratio was equal, and 43% were complex (13 of 30). Among these 30 secondary FS cases, the mean number of FSs was 2.1, half had only a single FS, and none had afebrile seizures. Penetrance was 0.67, approximately the same as in our previous larger group of 40 multicase FS families (0.64). The occurrence of DPT encephalopathy in a sib of a patient with FS raises the possibility that these two etiologies are related. Linkage studies showed that one of the four families (Family 1) was linked to chromosome 19p markers, none of the families was linked to chromosome 8q markers, and the largest FS family (Kindred 6) was unlinked to either 19p or 8q markers, supporting the hypothesis of genetic heterogeneity for FS.

Chromosomes, Human, Pair 19

Genetics of the febrile seizure susceptibility trait.

Febrile seizures are the commonest form of convulsion, occurring in 2-5% of infants in Europe and North America and 6-9% of infants in Japan. In large families, the febrile seizure susceptibility trait is inherited by the autosomal dominant pattern with reduced penetrance. In the other families, inheritance appears to be multifactorial. Recent linkage studies provide evidence that regions of chromosomes 8 and 19 contain febrile convulsions (FC) susceptibility genes. This opens up the way to cloning a febrile seizure gene and determining the contributions of these gene loci to febrile seizures in the sporadic cases and the small families. Cloning a febrile seizure gene will make possible new approaches to prevention and therapy. It will also be possible to determine whether a febrile seizure gene contributes to other types of seizures.

Chromosomes, Human, Pair 19

Topiramate efficacy in infancy.

Topiramate is a sulfamate-substituted monosaccharide that has demonstrated efficacy as an antiepileptic drug in adults with partial onset seizures. Experience in children has been limited, but early reports have supported its safety and effectiveness in children as young as 2 years of age. In two infants ages 12 and 9 months, respectively, with partial seizures, the authors report excellent efficacy with good tolerability at doses up to 7.7 mg/kg. Although long-term safety and possible adverse sequelae have not been fully established in children, topiramate may represent an option for infants with high seizure frequency unresponsive to standard antiepileptic drugs.

Anticonvulsants

Pedigree analysis in families with febrile seizures.

Febrile seizures are the most common form of seizures, occurring in an estimated 2-5% of North American children. We carried out a systematic pedigree study of febrile seizure probands. Forty of 52 probands (77%) in a referral population selected for increased severity had more than one case per family: one family had 10 cases, one family had 7, 3 families had 6, 2 had 5, 3 had 4, 13 had 3, and 17 had 2 cases. Mode of inheritance in the multicase families best fit the hypothesis of autosomal dominance with reduced penetrance. Polygenic inheritance could not be excluded for some of the smaller families. There was no support for X-linked or mitochondrial inheritance. Penetrance was calculated to be 0.64. Because the cases were selected for increased severity, this represents a useful estimate of the upper limit of penetrance and is in agreement with twin studies. Simulated lod scores showed adequate power for a linkage study in the absence of heterogeneity. Individual families had simulated average lod scores as high as 2.1. However, with potential heterogeneity, assuming only 70% of families share the same disease locus, average lod scores were marginal, and a high density map of marker loci and additional families would be required to document linkage.

Databases, Factual

Hypothermia and systemic lupus erythematosus.

We describe an 18-year-old black woman with systemic lupus erythematosus (SLE) who presented with an exacerbation of polymyositis and neuropsychiatric symptoms. After starting prednisone she became hypothermic for 5 days. Hypothermia associated with SLE has been described in only 3 patients.

Adolescent

Acute hemiplegia associated with HIV infection.

An acute hemiplegia secondary to a large cerebral infarct is described in a 16-month-old infant with congenitally-acquired human immunodeficiency virus infection. Serial imaging studies during the next year documented improvement in his hemiplegia and a static underlying human immunodeficiency virus encephalopathy. Acquired immunodeficiency syndrome should be included in the differential diagnosis of children with acute hemiplegia.

AIDS Dementia Complex