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Introduction: Dravet syndrome, also known as severe myoclonic epilepsy in infancy, is a drug resistant epileptic encephalopathy that usually begins in the first year of life. It is characterized by the presence of epileptic seizures that usually have multiple triggers; the most currently associated is the presence of previous febrile episodes. It is considered as a rare disease due to its low incidence and prevalence. Case presentation: We reported the case of a ten-year-old boy with structural epilepsy associated with a neurodevelopmental delay and minor craniofacial anomalies. He had a history of uncorrected congenital heart disease, colpocephaly, and agenesis of the corpus callosum. Due to the persistence of seizures secondary to drug resistance, it was decided to perform a genetic exome that evidenced a mutation of the SCN9A gene. Conclusions: Dravet syndrome should be suspected in all patients under one year of age who have recurrent seizures associated with fever that does not respond to medication and modifies its presentation. Approximately 70%−85% of the patients diagnosed with Dravet syndrome have a mutation in the SCN1A gene; therefore, mutations in other genes that encode sodium channels located on the same chromosome, such as SCN9A, could contribute in a multifactorial way. 

Suescún-Vargas, J. M., Pinzon-Salamanca, J. Y., Laverde-Hernández, J., Ayala-Olaya, D., & Gonzalez-Moreno, A. M. (2022). Mutation in the SCN9A Gene Associated with Dravet Syndrome: A Pediatric Case Report. Revista Ciencias De La Salud, 20(1). https://doi.org/10.12804/revistas.urosario.edu.co/revsalud/a.10238

Mingarro Castillo MM, Carmona de la Morena J, Latre Martínez P, Aras Portilla Luis Miguel. Síndrome de Dravet. Rev Clin Med Fam. 2014;7(2):134-6. https://doi.org/10.4321/S1699-695X2014000200008

Mulley JC, Hodgson B, McMahon JM, Iona X, Bellows S, Mullen SA, et al. Role of the sodium channel SCN9A in genetic epilepsy with febrile seizures plus and Dravet syndrome. Epilepsia. 2013;54(9):122-6. https://doi.org/10.1111/epi.12323

Connolly MB. Dravet syndrome: diagnosis and long-term course. Can J Neurol Sci. 2016;43(S3): S3-S8. https://doi.org/10.1017/cjn.2016.243

Danielle A, Nascimento F. Dravet syndrome: genetics, clinical features, and diagnosis. Uptodate [internet]. 2020 jul 21. Disponible en: https://www-uptodate-com.ez.urosario.edu.co/contents/dravet-syndrome-genetics-clinical-features-and-diagnosis?search=dravet&source=search_result&selectedTitle=2~33&usage_type=default&display_rank=2

Steel D, Symonds JD, Zuberi SM, Brunklaus A. Dravet syndrome and its mimics: beyond SCN1A. Epilepsia. 2017;58(11):1807-16. https://doi.org/10.1111/epi.13889

Pérez AB, Moreno N. Síndrome de Dravet. Salus. 2015;19(3):27-30.

Singh NA, Pappas C, Dahle EJ, Claes LR, Pruess TH, De Jonghe P, et al. A role of SCN9A in human epilepsies, as a cause of febrile seizures and as a potential modifier of Dravet syndrome. PLoS Genet. 2009;5(9):e1000649. https://doi.org/10.1371/journal.pgen.1000649

Fasham J, Leslie JS, Harrison JW, Deline J, Williams KB, Kuhl A, et al. No association between SCN9A and monogenic human epilepsy disorders. PLoS Genet. 2020;16(11):e1009161. https://doi.org/10.1371/journal.pgen.1009161

Yang C, Hua Y, Zhang W, Xu J, Xu L, Gao F, et al. Variable epilepsy phenotypes associated with het- erozygous mutation in the SCN9A gene: report of two cases. Neurol Sci. 2018;39(6):1113-5. https://doi.org/10.1007/s10072-018-3300-y

Cen Z, Lou Y, Guo Y, Wang J, Feng J. Q10R mutation in SCN9A gene is associated with generalized epilepsy with febrile seizures plus. Seizure. 2017;50:186-8. https://doi.org/10.1016/j.seizure.2017.06.023 PMID: 28704742

Liu Z, Ye X, Qiao P, Luo W, Wu Y, He Y, et al. G327E mutation in SCN9A gene causes idiopathic focal epilepsy with Rolandic spikes: a case report of twin sisters. Neurol Sci. 2019;40(7):1457-60. https://doi.org/10.1007/s10072-019-03752-3

Villas N, Meskis MA, Goodliffe S. Dravet syndrome: characteristics, comorbidities, and caregiver concerns. Epilepsy Behav. 2017 sep;74:81-6. https://doi.org/10.1016/j.yebeh.2017.06.031

Guerrini R, Striano P. Dravet syndrome: not just epilepsy. Neurology. 2016 jul;19;87(3):245-6. https://doi.org/10.1212/WNL.0000000000002873

Mei D, Cetica V, Marini C, Guerrini R. Dravet syndrome as part of the clinical and genetic spectrum of sodium channel epilepsies and encephalopathies. Epilepsia. 2019;60 Suppl 3:S2-S7. https://doi.org/10.1111/epi.16054

Wirrell EC, Laux L, Donner E, Jette N, Knupp K, Meskis MA, et al. Optimizing the diagnosis and management of Dravet syndrome: recommendations from a North American Consensus Panel. Pediatr Neurol. 2017; 68:18-34. https://doi.org/10.1016/j.pediatrneurol.2017.01.025

Hattori J, Ouchida M, Ono J, Miyake S, Maniwa S, Mimaki N, et al. A screening test for the prediction of Dravet syndrome before one year of age. Epilepsia. 2008;49(4):626-33. https://doi.org/10.1111/j.1528-1167.2007. 01475.x

Proposal for revised classification of epilepsies and epileptic syndromes. Commission on Classification and Terminology of the International League Against Epilepsy. Epilepsia. 1989;30(4):389-99. https://doi.org/10.1111/j.1528-1157.1989.tb05316.x

Carpintero RS. Diagnóstico temprano del síndrome de Dravet: aportaciones de la clínica y la biología molecular. Rev Neurol. 2011;52(11):681-8. https://doi.org/10.33588/rn.5211.2010771

Pasquale S, Mancardi MM, Biancheri R, Madia F, Gennaro E, Paravidino R, et al. Brain MRI findings in severe myoclonic epilepsy in infancy and genotype-phenotype correlations. Epilepsia. 2007;48(6):1092-6. https://doi.org/10.1111/j.1528-1167.2007.01020.x

Siegler S, Barsi P, Neuwirth M, Jerney J, Kassay M, Janszky J, et al. Hippocampal sclerosis in severe myoclonic epilepsy in infancy: a retrospective mri study. Epilepsia. 2005;46(5):704-8. https://doi.org/10.1111/j.1528-1167.2005.41604.x

Chiron C, Olivier D The pharmacologic treatment of Dravet syndrome. Epilepsia. 2011;52 Suppl 2:72-5. https://doi.org/10.1111/j.1528-1167.2011. 03007.x

Seger-Kroll J, Portilla P, Dulac O, Chiron C. Topiramate in the treatment of highly refractory patients with Dravet syndrome. Neuropediatrics. 2006;37(6):325-9. https://doi.org/10.1055/s-2007-96486

Barrera-Nieto M, Candau R, Nieto-Jiménez M, Correa A, Portal del LR. Topiramate in the treatment of severe myoclonic epilepsy in infancy. Seizure. 2000;9(8):590-4. https://doi.org/10.1053/seiz.2000.0466

Fisher J. The anti-convulsant stiripentol acts directly on the gabaa receptor as a positive allosteric modulator. Neuropharmacology. 2009;56(1):190-7. https://doi.org/10.1016/j.neuropharm.2008.06.004

Banfi P, Coll M, Oliva A, Alcalde M, Striano P, Mauri M, et al. Lamotrigine induced Brugadapattern in a patient with genetic epilepsy associated with a novel variant in SCN9A. Gene. 2020;754:144847. https://doi.org/10.1016/j.gene.2020.144847

Nabbout R, Mistry A, Zuberi S, Villeneuve N, Gil-Nagel A, Sánchez-Carpintero, et al. Fenfluramine for treatment-resistant seizures in patients with Dravet syndrome receiving stiripentol-inclusive regimens a randomized clinical trial. JAMA Neurol. 2020;77(3):300-8. https://doi.org/10.1001/jamaneurol.2019.4113

Dressler A, Trimmel-Schwahofer P, Reithofer E, Mühlebner A, Gröppel G, Reiter-Fink E, Benninger F, Grassl R, Feucht M. Efficacy and tolerability of the ketogenic diet in Dravet syndrome — Comparison with various standard antiepileptic drug regimen. Epilepsy Res. 2015;109:81-9. https://doi.org/10.1016/j.eplepsyres.2014.10.014

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