2022 Overview of Metabolic Epilepsies

Understanding the genetic architecture of metabolic epilepsies is of paramount importance, both to current clinical practice and for the identification of further research directions. The main goals of our study were to identify the scope of metabolic epilepsies and to investigate their clinical presentation, diagnostic approaches and treatments. The International Classification of Inherited Metabolic Disorders and IEMbase were used as a basis for the identification and classification of metabolic epilepsies. Six hundred metabolic epilepsies have been identified, accounting for as much as 37% of all currently described inherited metabolic diseases (IMD). Epilepsy is a particularly common symptom in disorders of energy metabolism, congenital disorders of glycosylation, neurotransmitter disorders, disorders of the synaptic vesicle cycle and some other IMDs. Seizures in metabolic epilepsies may present variably, and most of these disorders are complex and multisystem. Abnormalities in routine laboratory tests and/or metabolic testing may be identified in 70% of all metabolic epilepsies, but in many cases they are non-specific. In total, 111 metabolic epilepsies (18% of all) have specific treatments that may significantly change health outcomes if diagnosed in time. Although metabolic epilepsies comprise an important and significant group of disorders, their real scope and frequency may have been underestimated.

Automated summary

Understanding the genetic architecture of metabolic epilepsies is crucial for clinical practice and further research. This study aimed to identify the scope of metabolic epilepsies and investigate their clinical presentation, diagnostic approaches, and treatments. A total of 600 metabolic epilepsies were identified, many of which are complex and multisystem disorders. Abnormalities in routine laboratory tests and/or metabolic testing can be found in 70% of metabolic epilepsies, though often nonspecific. Specific treatments exist for 18% of metabolic epilepsies, which can significantly improve health outcomes if diagnosed in time.