Recurrent stroke due to a novel voltage sensor mutation in Cav2.1 responds to verapamil

Familial hemiplegic migraine is characterized by recurrent migraine, hemiparesis, and ataxia. Causes may be mutations in calcium and sodium channels or in a subunit of the Na/K-ATPse. Migraine treatment with calcium channel blockers was only successful in some patients. Summary of Case- We describe...

Full description

Saved in:
Bibliographic Details
Published inStroke (1970) Vol. 42; no. 2; pp. e14 - e17
Main Authors Knierim, Ellen, Leisle, Lilia, Wagner, Christiane, Weschke, Bernhard, Lucke, Barbara, Bohner, Georg, Dreier, Jens P, Schuelke, Markus
Format Journal Article
LanguageEnglish
Published United States 01.02.2011
Subjects
Online AccessGet full text

Cover

Loading…
Abstract Familial hemiplegic migraine is characterized by recurrent migraine, hemiparesis, and ataxia. Causes may be mutations in calcium and sodium channels or in a subunit of the Na/K-ATPse. Migraine treatment with calcium channel blockers was only successful in some patients. Summary of Case- We describe a 6-year-old girl with recurrent ischemic strokes after minor head trauma associated with seizures, hemiparesis, fever, and altered consciousness. Genetic analysis revealed a spontaneous, novel dominant CACNA1A mutation (c.4046G→A, p.R1349Q) that removed a highly conserved arginine of the voltage sensing region of the P/Q-type Ca(v)2.1 channel. Because a homologous mutation in the tottering-5J mouse increased open probability of the channel as well as calcium influx, we treated the patient with the calcium channel blocker verapamil during characteristic prodromi after head trauma. Treatment was instantly effective and prevented a new stroke. CACNA1A mutations should be considered in the diagnostic workup of childhood stroke, especially if associated with ataxia and migraine.
AbstractList BACKGROUND AND PURPOSEFamilial hemiplegic migraine is characterized by recurrent migraine, hemiparesis, and ataxia. Causes may be mutations in calcium and sodium channels or in a subunit of the Na/K-ATPse. Migraine treatment with calcium channel blockers was only successful in some patients. Summary of Case- We describe a 6-year-old girl with recurrent ischemic strokes after minor head trauma associated with seizures, hemiparesis, fever, and altered consciousness. Genetic analysis revealed a spontaneous, novel dominant CACNA1A mutation (c.4046G→A, p.R1349Q) that removed a highly conserved arginine of the voltage sensing region of the P/Q-type Ca(v)2.1 channel. Because a homologous mutation in the tottering-5J mouse increased open probability of the channel as well as calcium influx, we treated the patient with the calcium channel blocker verapamil during characteristic prodromi after head trauma. Treatment was instantly effective and prevented a new stroke.CONCLUSIONSCACNA1A mutations should be considered in the diagnostic workup of childhood stroke, especially if associated with ataxia and migraine.
BACKGROUND AND PURPOSE{MDASH}: Familial hemiplegic migraine is characterized by recurrent migraine, hemiparesis, and ataxia. Causes may be mutations in calcium and sodium channels or in a subunit of the Na/K-ATPse. Migraine treatment with calcium channel blockers was only successful in some patients. SUMMARY OF CASE{MDASH}: We describe a 6-year-old girl with recurrent ischemic strokes after minor head trauma associated with seizures, hemiparesis, fever, and altered consciousness. Genetic analysis revealed a spontaneous, novel dominant CACNA1A mutation (c.4046G arrow right A, p.R1349Q) that removed a highly conserved arginine of the voltage sensing region of the P/Q-type Cav2.1 channel. Because a homologous mutation in the tottering-5J mouse increased open probability of the channel as well as calcium influx, we treated the patient with the calcium channel blocker verapamil during characteristic prodromi after head trauma. Treatment was instantly effective and prevented a new stroke. CONCLUSION{MDASH}: CACNA1A mutations should be considered in the diagnostic workup of childhood stroke, especially if associated with ataxia and migraine.
Familial hemiplegic migraine is characterized by recurrent migraine, hemiparesis, and ataxia. Causes may be mutations in calcium and sodium channels or in a subunit of the Na/K-ATPse. Migraine treatment with calcium channel blockers was only successful in some patients. Summary of Case- We describe a 6-year-old girl with recurrent ischemic strokes after minor head trauma associated with seizures, hemiparesis, fever, and altered consciousness. Genetic analysis revealed a spontaneous, novel dominant CACNA1A mutation (c.4046G→A, p.R1349Q) that removed a highly conserved arginine of the voltage sensing region of the P/Q-type Ca(v)2.1 channel. Because a homologous mutation in the tottering-5J mouse increased open probability of the channel as well as calcium influx, we treated the patient with the calcium channel blocker verapamil during characteristic prodromi after head trauma. Treatment was instantly effective and prevented a new stroke. CACNA1A mutations should be considered in the diagnostic workup of childhood stroke, especially if associated with ataxia and migraine.
Author Wagner, Christiane
Lucke, Barbara
Bohner, Georg
Knierim, Ellen
Weschke, Bernhard
Schuelke, Markus
Leisle, Lilia
Dreier, Jens P
Author_xml – sequence: 1
  givenname: Ellen
  surname: Knierim
  fullname: Knierim, Ellen
  organization: Department of Neuropediatrics, Charité Universitätsmedizin Berlin, D-13353 Berlin, Germany
– sequence: 2
  givenname: Lilia
  surname: Leisle
  fullname: Leisle, Lilia
– sequence: 3
  givenname: Christiane
  surname: Wagner
  fullname: Wagner, Christiane
– sequence: 4
  givenname: Bernhard
  surname: Weschke
  fullname: Weschke, Bernhard
– sequence: 5
  givenname: Barbara
  surname: Lucke
  fullname: Lucke, Barbara
– sequence: 6
  givenname: Georg
  surname: Bohner
  fullname: Bohner, Georg
– sequence: 7
  givenname: Jens P
  surname: Dreier
  fullname: Dreier, Jens P
– sequence: 8
  givenname: Markus
  surname: Schuelke
  fullname: Schuelke, Markus
BackLink https://www.ncbi.nlm.nih.gov/pubmed/21183743$$D View this record in MEDLINE/PubMed
BookMark eNqFkE1Lw0AYhBep2A_9ByJ785S638keS6lWLBRqxWPYJG8kmuzG3STgv7dqBW-eZgaemcNM0cg6CwhdUjKnVNGbx_1u-7BarBeHSOaKEML4CZpQyUQkFEtGf_wYTUN4_UYSeYbGjNKEx4JP0PMO8t57sB0OnXdvgIsecOewwdYNUOPB1Z15ARzABudx03emq5zFlcVLM7A5xR5C62wRvloDeNOapqrP0Wlp6gAXR52hp9vVfrmONtu7--ViE7VUxl2kBZO61DxOZB4D06KQSQaSZRJKbuIiFkpoSvKsLI3mCYmVAm5ySZnMlVYZn6Hrn93Wu_ceQpc2Vcihro0F14dUk5gKLYn8l0zE4RAqlT6QV0eyzxoo0tZXjfEf6e9r_BMFxXEF
ContentType Journal Article
DBID CGR
CUY
CVF
ECM
EIF
NPM
7X8
7TK
7U7
C1K
DOI 10.1161/STROKEAHA.110.600023
DatabaseName Medline
MEDLINE
MEDLINE (Ovid)
MEDLINE
MEDLINE
PubMed
MEDLINE - Academic
Neurosciences Abstracts
Toxicology Abstracts
Environmental Sciences and Pollution Management
DatabaseTitle MEDLINE
Medline Complete
MEDLINE with Full Text
PubMed
MEDLINE (Ovid)
MEDLINE - Academic
Toxicology Abstracts
Neurosciences Abstracts
Environmental Sciences and Pollution Management
DatabaseTitleList MEDLINE - Academic
Toxicology Abstracts
MEDLINE
Database_xml – sequence: 1
  dbid: NPM
  name: PubMed
  url: https://proxy.k.utb.cz/login?url=http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed
  sourceTypes: Index Database
– sequence: 2
  dbid: EIF
  name: MEDLINE
  url: https://proxy.k.utb.cz/login?url=https://www.webofscience.com/wos/medline/basic-search
  sourceTypes: Index Database
DeliveryMethod fulltext_linktorsrc
Discipline Medicine
EISSN 1524-4628
EndPage e17
ExternalDocumentID 21183743
Genre Research Support, Non-U.S. Gov't
Journal Article
Case Reports
GroupedDBID ---
.3C
.55
.GJ
.XZ
.Z2
01R
0R~
123
1J1
2WC
3O-
40H
4Q1
4Q2
4Q3
53G
5RE
5VS
6PF
71W
77Y
7O~
A9M
AAAAV
AAAXR
AAGIX
AAHPQ
AAIQE
AAJCS
AAMOA
AAMTA
AAQKA
AAQQT
AARTV
AASCR
AASOK
AAUEB
AAXQO
AAYEP
AAYJJ
ABASU
ABBUW
ABDIG
ABJNI
ABQRW
ABVCZ
ABXVJ
ABZAD
ACCJW
ACDDN
ACEWG
ACGFS
ACGOD
ACILI
ACLDA
ACWDW
ACWRI
ACXJB
ACXNZ
ADBBV
ADFPA
ADGGA
ADHPY
ADNKB
AE3
AE6
AEBDS
AEETU
AENEX
AFDTB
AFEXH
AFFNX
AFSOK
AFUWQ
AGINI
AHMBA
AHOMT
AHQNM
AHRYX
AHVBC
AIJEX
AINUH
AJIOK
AJNWD
AJNYG
AJZMW
AKULP
ALMA_UNASSIGNED_HOLDINGS
ALMTX
AMJPA
AMKUR
AMNEI
AOHHW
AWKKM
AYCSE
BAWUL
BCGUY
BOYCO
BQLVK
BS7
C45
CGR
CS3
CUY
CVF
DIK
DIWNM
DU5
DUNZO
E.X
E3Z
EBS
ECM
EEVPB
EIF
EJD
ERAAH
EX3
F2K
F2L
F2M
F2N
F5P
FCALG
FL-
FW0
GNXGY
GQDEL
GX1
H0~
H13
HLJTE
HZ~
IKREB
IKYAY
IN~
IPNFZ
J5H
JF9
JG8
JK3
JK8
K8S
KD2
KMI
KQ8
L-C
L7B
M18
N4W
N9A
NPM
N~7
N~B
N~M
O9-
OAG
OAH
OB3
OCUKA
ODA
ODMTH
OGROG
OHYEH
OJAPA
OK1
OL1
OLG
OLH
OLU
OLV
OLW
OLY
OLZ
OPUJH
ORVUJ
OUVQU
OVD
OVDNE
OVIDH
OVLEI
OVOZU
OWBYB
OWU
OWV
OWW
OWX
OWY
OWZ
OXXIT
P-K
P2P
PQQKQ
R58
RAH
RHF
RIG
RLZ
S4R
S4S
T8P
TEORI
TSPGW
TWZ
V2I
VVN
W3M
W8F
WH7
WOQ
WOW
X3V
X3W
X7M
XXN
XYM
YCJ
YFH
YHZ
YQJ
YYP
ZB8
ZGI
ZZMQN
7X8
7TK
7U7
C1K
ID FETCH-LOGICAL-p157t-94259f93785c7e294d58be52b5ef3a7d7464910cbffa9380766e3ac5125c696b3
ISSN 1524-4628
IngestDate Wed Dec 04 00:58:13 EST 2024
Wed Dec 04 04:02:02 EST 2024
Tue Oct 15 23:43:28 EDT 2024
IsPeerReviewed true
IsScholarly true
Issue 2
Language English
LinkModel OpenURL
MergedId FETCHMERGED-LOGICAL-p157t-94259f93785c7e294d58be52b5ef3a7d7464910cbffa9380766e3ac5125c696b3
Notes ObjectType-Case Study-2
SourceType-Scholarly Journals-1
ObjectType-Feature-4
content type line 23
ObjectType-Report-1
ObjectType-Article-3
ObjectType-Article-2
ObjectType-Feature-1
PMID 21183743
PQID 847431569
PQPubID 23479
ParticipantIDs proquest_miscellaneous_907149505
proquest_miscellaneous_847431569
pubmed_primary_21183743
PublicationCentury 2000
PublicationDate 2011-02-00
PublicationDateYYYYMMDD 2011-02-01
PublicationDate_xml – month: 02
  year: 2011
  text: 2011-02-00
PublicationDecade 2010
PublicationPlace United States
PublicationPlace_xml – name: United States
PublicationTitle Stroke (1970)
PublicationTitleAlternate Stroke
PublicationYear 2011
SSID ssj0002385
Score 2.2117963
Snippet Familial hemiplegic migraine is characterized by recurrent migraine, hemiparesis, and ataxia. Causes may be mutations in calcium and sodium channels or in a...
BACKGROUND AND PURPOSEFamilial hemiplegic migraine is characterized by recurrent migraine, hemiparesis, and ataxia. Causes may be mutations in calcium and...
BACKGROUND AND PURPOSE{MDASH}: Familial hemiplegic migraine is characterized by recurrent migraine, hemiparesis, and ataxia. Causes may be mutations in calcium...
SourceID proquest
pubmed
SourceType Aggregation Database
Index Database
StartPage e14
SubjectTerms Ataxia
Calcium channels
Calcium channels (voltage-gated)
Calcium Channels - genetics
Calcium Channels, N-Type - genetics
Calcium influx
Channel opening
Child
Children
Consciousness
Female
Fever
Genetic analysis
Head
Headache
Humans
Ischemia
Migraine
Mutation
Mutation - genetics
Paresis
Secondary Prevention
Sodium channels
Stroke
Stroke - drug therapy
Stroke - genetics
Stroke - prevention & control
Trauma
Verapamil
Verapamil - therapeutic use
Title Recurrent stroke due to a novel voltage sensor mutation in Cav2.1 responds to verapamil
URI https://www.ncbi.nlm.nih.gov/pubmed/21183743
https://search.proquest.com/docview/847431569
https://search.proquest.com/docview/907149505
Volume 42
hasFullText 1
inHoldings 1
isFullTextHit
isPrint
link http://utb.summon.serialssolutions.com/2.0.0/link/0/eLvHCXMwnV1Lj5swELbSrVT1UvXd7Us-9BaRJoAhPqZtVlHzWHWTbHNDxgwr1AiiLOyhv74z2CRI3VUfFxQhbBDzZfhmPN-YsQ_hIImVL4cOaBU7SKlTR2IY4QD09RACT6f1ZjDzRTBZ-183YtPpLFtVS1UZ9_TPW3Ul_2NVPId2JZXsP1j2MCmewN9oXzyihfH4Vza-oGR53V5pWe6LH9D9UtU7YajuoriBbfey2JZUk7PEWLXYd-eVLS0kpZ-6cXsDyt7vCiqKxVGXpMSifEebsNqJqZ2TDPutvME0z6hThSkN20Krsie7NiXKs2ybHZ2-urLSGtPOAFHZWhXCENsUCX2Cfd4I_ZtkBGVXD4Ud1n-6vkNy17aD9d0WkNyWtwSjH7UfXjAizt99ekA-fbm6OJ-OR5MRCRd6Qd2o5_gNa9btF-fR2Xo2i1bjzeoeu0_dEWlDhem3Ywt55CiibqJrn9TqKfEuH2-7x92RR81AVo_ZIxs68JHBwRPWgfwpezC3xRHP2PcDHLixGkc48LLgitdw4BYO3MCBN3DgWc4NHHgDBxp1gMNztj4brz5PHLtvhrMbiLDEPxvGtCnyzqHQIbjST8QwBuHGAlJPhUnoBz6yRB2nqZK04UAQgKc0Uj-hAxnE3gt2khc5vGK8vjbug3LBw9A_kQkoIYRWXiq00INTxpu3E6FfosUmhE9RXUfIepCbikDefYkk8ZxECn7KXpoXG-1Mi5XIxbjXwwle_3nwG_bwiMS37KTcV_AOiWIZv68N_wvoImd1
link.rule.ids 314,780,784,27924,27925
linkProvider Colorado Alliance of Research Libraries
openUrl ctx_ver=Z39.88-2004&ctx_enc=info%3Aofi%2Fenc%3AUTF-8&rfr_id=info%3Asid%2Fsummon.serialssolutions.com&rft_val_fmt=info%3Aofi%2Ffmt%3Akev%3Amtx%3Ajournal&rft.genre=article&rft.atitle=Recurrent+Stroke+Due+to+a+Novel+Voltage+Sensor+Mutation+in+Cav2.1+Responds+to+Verapamil&rft.jtitle=Stroke+%281970%29&rft.au=Knierim%2C+Ellen&rft.au=Leisle%2C+Lilia&rft.au=Wagner%2C+Christiane&rft.au=Weschke%2C+Bernhard&rft.date=2011-02-01&rft.issn=1524-4628&rft.volume=42&rft.issue=2&rft.spage=e14&rft.epage=e17&rft_id=info:doi/10.1161%2FSTROKEAHA.110.600023&rft.externalDBID=NO_FULL_TEXT
thumbnail_l http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/lc.gif&issn=1524-4628&client=summon
thumbnail_m http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/mc.gif&issn=1524-4628&client=summon
thumbnail_s http://covers-cdn.summon.serialssolutions.com/index.aspx?isbn=/sc.gif&issn=1524-4628&client=summon