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ジストロフィノパチーは中枢神経症状の合併が多く,4〜15%に熱性けいれん,2〜12%にてんかんを認めるとされている。自験例では,熱性けいれんは8%にあり,エクソン45より3'末端側,特にエクソン63より下流の変異例で多く,てんかんは5%に認め,デュシェンヌ型よりベッカー型で多かった。中枢神経に発現するアイソフォームDp427,Dp71などの欠損がGABAA受容体,アクアポリン4,Kチャネル障害を引き起こし,けいれん合併に関連している可能性がある。
Abstract
Dystrophinopathy is associated strongly with central nervous system manifestation. It has been reported that 4%-15% of patients with dystrophinopathy have febrile seizure, and 2%-12% have epilepsy. In our study, 8% of patients had febrile seizure, and it was more common in patients with mutations downstream of exon 45, especially exon 63. Epilepsy occurred in 5% of our patients, and the prevalence in Becker muscular dystrophy was higher than that in Duchenne muscular dystrophy. Isoforms such as Dp427 and Dp71, expressed in the central nervous system. might be related to seizure, because of impairment in GABAA receptors, aquaporin 4, and K channels.
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