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Faulty gene may explain sudden deaths in epilepsy
Published in Saudi Press Agency on 14 - 10 - 2009

A common gene that can cause abnormal heart rhythms can also trigger epileptic seizures in
the brain and may explain the sudden, unexplained deaths that
often occur in people with epilepsy, Reuters quoted U.S. researchers as saying today.
Testing epileptics for a mutation in this gene could give
doctors the information they need to prevent some of these
deaths, said Dr. Jeffrey Noebels of Baylor College of Medicine,
whose study appears in the journal Science Translational
Medicine.
Doctors have long known that patients with a mutation in
the the gene KvLQT1 -- which makes structures called ion
channels that regulate electrical activity in the heart -- have
a greater risk of sudden death from abnormal heart rhythms.
This gene also makes ion channels in brain cells, Noebels
and colleagues found.
"We call it the missing link," Noebels said in a telephone
interview. He believes the mutation in the brain triggers the
seizure and may also trigger the heart disturbance, which in
turn kills patients.
In patients with epilepsy, clusters of nerve cells called
neurons in the brain send out the wrong signals, causing
seizures. People with epilepsy are 23 times more likely to
suddenly die from unexplained causes, but until now, doctors
had no idea why, Noebels said.
"We hypothesized that if this same protein called an ion
channel was in the brain, it could alter the way brain rhythms
occur and trigger an epileptic seizure," Noebels said.
He said ion channels act like circuit breakers. "They
regulate the way cells fire in electrical patterns."
The team used antibodies -- immune system proteins that
home in on specific molecules -- to find the effects of the ion
channel mutation in brain samples from mice and humans.
"We found it in the brain. That meant it could be the
culprit in causing epilepsy," Noebels said.
They also measured heart rates and brain waves in mice that
had been genetically engineered to have the human genetic
mutations that make defective ion channels in the heart.
"We saw they were having electrical seizures in the brain
that corresponded with heart rhythm disturbances," Noebels
said. "We actually witnessed a death in a mouse that was due to
the defective channel," he said.
Noebels said he suspects the defective gene is one of
several that causes epileptic seizures.
"What this tells us is we need to encourage physicians to
send patients to a cardiologist for an evaluation. They possess
the tests for this class of genes to assess whether a patient
is at increased risk for sudden death," he said.
In heart patients with this genetic defect, he said
inexpensive drugs known as beta blockers and pacemakers can
help regulate dangerous heartbeats.


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