Autosomal dominant lateral temporal epilepsy (ADLTE) (OMIM 600512), or autosomal dominant partial epilepsy with auditory features, is an inherited epileptic syndrome characterized by focal seizures with ictal auditory phenomena or other symptoms suggesting a lateral temporal lobe onset of discharge.
1-3 Seizures may be triggered by environmental sounds or noises, and secondarily generalized tonic-clonic seizures (TCSs) are almost invariably present but occur sporadically. The evolution of the condition is relatively benign because seizures are usually well controlled with standard antiepileptic drugs.
3,4 Conventional brain magnetic resonance imaging results are normal and electroencephalograms (EEGs) frequently show mild temporal abnormalities. Mutations in the leucine-rich, glioma-inactivated 1 (
LGI1) gene (GenBank 9211), also named
Epitempin, are found in about 50% of the families, compatible with autosomal dominant inheritance with reduced penetrance and suggesting that ADLTE is genetically heterogeneous.
3-5 The
LGI1 gene is mainly expressed in brain tissues and shows no homology with known ion channel genes. It encodes a protein whose predicted structure consists of 4 LRR repeats
6 in the N-terminal portion and 7 EPTP repeats
7 in the C-terminal region, each domain defining a distinct family of proteins exerting a variety of functions. The function of
LGI1 is unclear. Recent in vitro experiments have shown that the Lgi1 protein produced by transfected cells is secreted.
8,9