J Genet Med.  2021 Jun;18(1):55-59. 10.5734/JGM.2021.18.1.55.

West syndrome with hyperkinesia and cortical visual impairment: A case report of GRIN1 encephalopathy

• Choi SA
• Kim YO

• KMID: 2517213
• DOI: http://doi.org/10.5734/JGM.2021.18.1.55

Abstract

West syndrome (WS) presenting with infantile spasms, developmental delay, and hypsarrhythmia has genetic etiology in some patients. Movement disorders or visual impairment that share genetic underpinnings with infantile spasms can provide diagnostic clues for specific genetic mutations. Mutations of the GRIN1 gene encoding the glutamate receptor inotropic Nmethyl-D-aspartate subunit can result in WS with hyperkinetic movements, cortical visual impairment, autistic features, and bilateral polymicrogyria. An 11-month-old boy with WS showed hyperkinetic movements and visual impairment. Brain magnetic resonance imaging and metabolic investigations revealed no abnormalities. Whole-exome sequencing revealed a novel likely pathogenic variant (c.1561_1563del; p.Asn521del) of GRIN1 (NM_007327.3). The proband was treated with vigabatrin and became seizure-free within one week. Notably, the cortical blindness improved within 3 months and the hyperkinetic movements resolved one year after the proband became seizure-free. To the best of our knowledge, this is the first report of GRIN1 encephalopathy in Koreans.

Keyword

Glutamate receptors; Infantile spasms; Hyperkinesis; Blindness