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X-linked epilepsies are a heterogeneous group of epileptic conditions, which often overlap with X-linked intellectual disability. To date, various X-linked genes responsible for epilepsy syndromes and/or developmental and epileptic encephalopathies have been recognized. The electro-clinical phenotype is well described for some genes in which epilepsy represents the core symptom, while less phenotypic details have been reported for other recently identified genes. In this review, we comprehensively describe the main features of both X-linked epileptic syndromes thoroughly characterized to date (-related DEE, -related DEE, -related disorders), forms of epilepsy related to X-linked neuronal migration disorders (e.g., , , ) and DEEs associated with recently recognized genes (e.g., , , , , , , , , , , , ). It is often difficult to suspect an X-linked mode of transmission in an epilepsy syndrome. Indeed, different models of X-linked inheritance and modifying factors, including epigenetic regulation and X-chromosome inactivation in females, may further complicate genotype-phenotype correlations. The purpose of this work is to provide an extensive and updated narrative review of X-linked epilepsies. This review could support clinicians in the genetic diagnosis and treatment of patients with epilepsy featuring X-linked inheritance.
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http://dx.doi.org/10.3390/ijms25074110 | DOI Listing |
Clin Genet
August 2025
Department of Pediatrics, Tohoku University Graduate School of Medicine, Sendai, Japan.
Connector enhancer of kinase suppressor of Ras2 (CNKSR2) is critical in neuronal dendrite growth. Hemizygous pathogenic variants of CNKSR2, which is located at Xp22.12, are associated with intellectual disability, epilepsy, and developmental and epileptic encephalopathy with spike wave activation during sleep.
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August 2025
Department of Pediatrics, University of Utah, Salt Lake City, Utah, USA.
Genetic testing via multigene panels has become common practice for children with epilepsy. This results in frequent identification of variants of uncertain significance (VUS). Providers must then assess clinical suspicion of the VUS, considering clinical correlation, family variant testing, and laboratory contact for internal case data.
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August 2025
Department of Pediatrics, Division of Pediatric Neurology, Sidra Medicine, Doha, Qatar.
Background: Duchenne muscular dystrophy (DMD) and Becker muscular dystrophy (BMD) are rare X-linked neuromuscular disorders that typically begin in childhood and progress to functional decline, loss of ambulation, and early death due to cardiac or respiratory failure.
Objective: To describe the landscape of DMD and BMD in Qatar, including demographics, genetics, disease progression, risk factors, co-morbidities, and outcomes in patients aged 3-30 years, and compare findings with international data.
Methods: We retrospectively reviewed records of all genetically confirmed or biopsy-supported cases of DMD and BMD between 2018 and 2024 at Sidra Medicine, the sole pediatric tertiary center in Qatar.
Neuromuscul Disord
July 2025
Neurology Department, CHU d'Angers, France; Institute of Neurobiology and Neuropathology CHU d'Angers, France; Neuromuscular Reference Center, Department of Neurology, CHU d'Angers, France; MITOLAB, INSERM U1083, France. Electronic address:
McLeod syndrome (MLS) is an ultra-rare X-linked multisystem disorder characterized by neurological involvement and distinctive hematological features, including acanthocytosis and specific blood group antigens. The clinical picture is typically dominated by central nervous system manifestations, such as movement disorders, cognitive and psychiatric disturbances, and epilepsy, while subclinical neuromuscular involvement is common. The function of the XK protein and the disease pathophysiology remain poorly understood.
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