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<article article-type="research-article" dtd-version="1.3" xmlns:mml="http://www.w3.org/1998/Math/MathML" xmlns:xlink="http://www.w3.org/1999/xlink" xmlns:xsi="http://www.w3.org/2001/XMLSchema-instance" xml:lang="en"><front><journal-meta><journal-id journal-id-type="publisher-id">epilepsia</journal-id><journal-title-group><journal-title xml:lang="en">Epilepsy and paroxysmal conditions</journal-title><trans-title-group xml:lang="ru"><trans-title>Эпилепсия и пароксизмальные состояния</trans-title></trans-title-group></journal-title-group><issn pub-type="ppub">2077-8333</issn><issn pub-type="epub">2311-4088</issn><publisher><publisher-name>IRBIS LLC</publisher-name></publisher></journal-meta><article-meta><article-id pub-id-type="doi">10.17749/2077-8333/epi.par.con.2022.111</article-id><article-id custom-type="elpub" pub-id-type="custom">epilepsia-772</article-id><article-categories><subj-group subj-group-type="heading"><subject>Research Article</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="en"><subject>CLINICAL CASES</subject></subj-group><subj-group subj-group-type="section-heading" xml:lang="ru"><subject>КЛИНИЧЕСКИЕ СЛУЧАИ</subject></subj-group></article-categories><title-group><article-title>Myoclonic epilepsy with ragged red fibers in childhood</article-title><trans-title-group xml:lang="ru"><trans-title>Миоклоническая эпилепсия с разорванными красными волокнами в детском возрасте</trans-title></trans-title-group></title-group><contrib-group><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-5809-1457</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Тадтаева</surname><given-names>З. Г.</given-names></name><name name-style="western" xml:lang="en"><surname>Tadtaeva</surname><given-names>Z. G.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Тадтаева Зара Григорьевна – доктор медицинских наук, профессор кафедры фармакологии с курсом клинической фармакологии и фармакоэкономики.</p><p>ул. Литовская, д. 2, Санкт-Петербург 194100.</p><p>РИНЦ SPIN-код: 6086-0169</p></bio><bio xml:lang="en"><p>Zara G. Tadtaeva  – Dr. Med. Sc., Professor, Chair of Pharmacology with the Course of Clinical Pharmacology and Pharmacoeconomics, Saint Petersburg  Pediatric Medical University.</p><p>2 Litovskaya Str., Saint Petersburg 194100.</p><p>RSCI SPIN-code: 6086-0169</p></bio><email xlink:type="simple">Tadtaeva2003@mail.ru</email><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0001-9679-632X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Галустян</surname><given-names>А. Н.</given-names></name><name name-style="western" xml:lang="en"><surname>Galustyan</surname><given-names>A. N.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Галустян Анна Николаевна – кандидат медицинских наук, доцент, заведующая кафедрой  фармакологии с курсом клинической фармакологии и фармакоэкономики.</p><p>ул. Литовская, д. 2, Санкт-Петербург 194100.</p><p>РИНЦ SPIN-код: 3303-7650</p></bio><bio xml:lang="en"><p>Anna N. Galustyan – MD, PhD, Associate Professor, Chief of Chair of Pharmacology with the Course of Clinical Pharmacology and Pharmacoeconomics, Saint Petersburg  Pediatric Medical  University.</p><p>2 Litovskaya Str., Saint Petersburg 194100.</p><p>RSCI SPIN-code: 3303-7650</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-6725-8036</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кривдина</surname><given-names>М. Ю.</given-names></name><name name-style="western" xml:lang="en"><surname>Krivdina</surname><given-names>М. Yu.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кривдина Марина Юрьевна – невролог психоневрологического отделения.</p><p>ул. Литовская, д. 2, Санкт-Петербург 194100.</p></bio><bio xml:lang="en"><p>Marina Yu. Krivdina – Neurologist, Psychoneurological Department, Saint Petersburg Pediatric Medical University.</p><p>2 Litovskaya Str., Saint Petersburg 194100.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0432-7946</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Русановский</surname><given-names>В. В.</given-names></name><name name-style="western" xml:lang="en"><surname>Rusanovsky</surname><given-names>V. V.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Русановский Владимир Васильевич – доктор медицинских наук, профессор  кафедры фармакологии с курсом  клинической фармакологии и фармакоэкономики.</p><p>ул. Литовская, д. 2, Санкт-Петербург 194100.</p><p>РИНЦ SPIN-код: 7010-4530</p></bio><bio xml:lang="en"><p>Vladimir  V. Rusanovsky  – Dr.  Med.  Sc., Professor,  Chair  of Pharmacology  with  the  Course  of Clinical  Pharmacology  and Pharmacoeconomics, Saint Petersburg  Pediatric Medical  University.</p><p>2 Litovskaya Str., Saint Petersburg 194100.</p><p>RSCI SPIN-code: 7010-4530</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0003-1400-6967</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Ефет</surname><given-names>Е. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Efet</surname><given-names>E. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Ефет Елена Анатольевна – кандидат медицинских наук, заведующая психоневрологическим отделением.</p><p>ул. Литовская, д. 2, Санкт-Петербург 194100.</p></bio><bio xml:lang="en"><p>Elena A. Efet – MD, PhD, Head of Psychoneurological Department, Saint Petersburg Pediatric Medical University.</p><p>2 Litovskaya Str., Saint Petersburg 194100.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-4714-1180</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Кривошеин</surname><given-names>А. Е.</given-names></name><name name-style="western" xml:lang="en"><surname>Krivoshein</surname><given-names>A. Е.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Кривошеин Александр Евгеньевич – студент.</p><p>ул. Литовская, д. 2, Санкт-Петербург 194100.</p></bio><bio xml:lang="en"><p>Aleksandr  E. Krivoshein – Student, Saint Petersburg  Pediatric Medical University.</p><p>2 Litovskaya Str., Saint Petersburg 194100.</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-0200-5097</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Курицына</surname><given-names>Н. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Kuritsyna</surname><given-names>N. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Курицына Наталия Андреевна – кандидат медицинских наук, доцент кафедры фармакологии с курсом клинической фармакологии  и фармако-экономики.</p><p>ул. Литовская, д. 2, Санкт-Петербург 194100.</p><p>РИНЦ SPIN-код: 4361-7365</p></bio><bio xml:lang="en"><p>Natalia A. Kuritsyna – MD, PhD,  Associate  Professor,  Chair  of Pharmacology  with the Course  of Clinical  Pharmacology  and Pharmacoeconomics, Saint Petersburg  Pediatric Medical  University.</p><p>2 Litovskaya Str., Saint Petersburg 194100.</p><p>RSCI SPIN-code: 4361-7365</p></bio><xref ref-type="aff" rid="aff-1"/></contrib><contrib contrib-type="author" corresp="yes"><contrib-id contrib-id-type="orcid">https://orcid.org/0000-0002-7663-710X</contrib-id><name-alternatives><name name-style="eastern" xml:lang="ru"><surname>Громова</surname><given-names>О. А.</given-names></name><name name-style="western" xml:lang="en"><surname>Gromova</surname><given-names>О. A.</given-names></name></name-alternatives><bio xml:lang="ru"><p>Громова Ольга Алексеевна – доктор медицинских наук, профессор, научный руководитель.</p><p>ул. Вавилова, д. 4, Москва 119333.</p><p>Scopus Author ID: 7003589812</p><p>WoS ResearcherID: J-4946-2017</p><p>РИНЦ SPIN-код: 6317-9833</p></bio><bio xml:lang="en"><p>Olga A. Gromova – Dr. Med. Sc., Professor, Research Supervisor, Federal Research Center “Informatics and Management”, RAS.</p><p>4 Vavilov Str., Moscow 119333.</p><p>Scopus  Author ID: 7003589812</p><p>WoS ResearcherID: J-4946-2017</p><p>RSCI SPIN-code: 6317-9833</p></bio><xref ref-type="aff" rid="aff-2"/></contrib></contrib-group><aff-alternatives id="aff-1"><aff xml:lang="ru"><institution>Санкт-Петербургский педиатрический медицинский университет Министерства здравоохранения</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Saint Petersburg Pediatric Medical University</institution><country>Russian Federation</country></aff></aff-alternatives><aff-alternatives id="aff-2"><aff xml:lang="ru"><institution>Федеральный исследовательский центр «Информатика и управление» Российской академии наук</institution><country>Россия</country></aff><aff xml:lang="en"><institution>Federal Research Center “Informatics and Management”, Russian Academy of Sciences</institution><country>Russian Federation</country></aff></aff-alternatives><pub-date pub-type="collection"><year>2022</year></pub-date><pub-date pub-type="epub"><day>17</day><month>04</month><year>2022</year></pub-date><volume>14</volume><issue>1</issue><fpage>28</fpage><lpage>36</lpage><permissions><copyright-statement>Copyright &amp;#x00A9; Tadtaeva Z.G., Galustyan A.N., Krivdina М.Y., Rusanovsky V.V., Efet E.A., Krivoshein A.Е., Kuritsyna N.A., Gromova О.A., 2022</copyright-statement><copyright-year>2022</copyright-year><copyright-holder xml:lang="ru">Тадтаева З.Г., Галустян А.Н., Кривдина М.Ю., Русановский В.В., Ефет Е.А., Кривошеин А.Е., Курицына Н.А., Громова О.А.</copyright-holder><copyright-holder xml:lang="en">Tadtaeva Z.G., Galustyan A.N., Krivdina М.Y., Rusanovsky V.V., Efet E.A., Krivoshein A.Е., Kuritsyna N.A., Gromova О.A.</copyright-holder><license xml:lang="ru" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>Данная работа распространяется под лицензией Creative Commons Attribution 4.0.</license-p></license><license xml:lang="en" license-type="creative-commons-attribution" xlink:href="https://creativecommons.org/licenses/by/4.0/" xlink:type="simple"><license-p>This work is licensed under a Creative Commons Attribution 4.0 License.</license-p></license></permissions><self-uri xlink:href="https://www.epilepsia.su/jour/article/view/772">https://www.epilepsia.su/jour/article/view/772</self-uri><abstract><p>Myoclonic epilepsy with ragged  red fibers (MERRF) is a maternally inherited disease characterized by myoclonic epilepsy, cerebellar ataxia and progressive muscle weakness. Development of the disease is associated with the most common  (90% of cases)  point mutation at position 8344 in the mitochondrial lysine transport RNA gene – MTTLys. The disease diagnostics causes  certain difficulties due to the insufficient awareness of this pathology and polymorphism of clinical manifestations. The article presents a brief review of the literature data on current views on the disease pathogenesis, diagnostic methods and opportunities for drug treatment, and describes a clinical observation of a 7-year-old child with MERRF syndrome caused by a point  mutation  at position 8344  in the MTTLys gene.  The girl was under dynamic  supervision  at the neuropsychiatric department.  A comprehensive clinical, laboratory and instrumental examination was carried out that also included molecular genetic testing. The progredient progression and multiple symptoms of the disease, slightly increased lactate acidosis in the absence of typical neuroimaging and electromyographic changes are of interest in the observation, thereby confirming they might not necessarily be observed in MERRF. Intrafamily clinical diversity was noted in the absence of signs of the disease in paired mother.  A highly informative  method of MERRF diagnostics is provided by molecular genetic testing. Establishing a genetic diagnosis underlies a need for conducting medical and genetic counseling for family planning to prevent the re-birth of other sick siblings inheriting this pathology.</p></abstract><trans-abstract xml:lang="ru"><p>Миоклоническая эпилепсия с разорванными  красными волокнами (англ. myoclonic epilepsy  with ragged  red fibers, MERRF) – наследуемое по материнской линии заболевание,  характеризующееся  миоклонической  эпилепсией, мозжечковой атаксией и прогрессирующей  мышечной слабостью.  Его развитие связано  с наиболее часто (90% случаев) встречаемой точечной мутацией в позиции 8344 в гене митохондриальной  лизиновой  транспортной  РНК – MTTLys. Диагностика вызывает определенные трудности в связи с недостаточной информированностью  практикующих врачей о данной патологии и полиморфизмом  клинических проявлений. Проведен краткий обзор  литературных данных по современным  представлениям о патогенезе заболевания, методам диагностики и возможностям  медикаментозного лечения, а также описано клиническое наблюдение синдрома MERRF у ребенка  6 лет, обусловленного точечной мутацией в позиции 8344 в гене MTTLys. Девочка находилась под динамическим наблюдением в психоневрологическом отделении. Выполнено комплексное клинико-лабораторное и инструментальное обследование,  включая молекулярно-генетическое тестирование. Представляют интерес прогредиентность  и многосимптомность  заболевания, легкое повышение лактат-ацидоза при отсутствии  типичных нейровизуализационных и электромиографических изменений, что подтверждает необязательность их наличия при MERRF. Отмечено внутрисемейное клиническое разнообразие при отсутствии признаков болезни у матери. Высокоинформативным методом диагностики MERRF является молекулярно-генетическое  тестирование. Установление генетического  диагноза диктует необходимость медико-генетического консультирования для планирования семьи и предупреждения повторного  рождения больного  ребенка с наследственной патологией.</p></trans-abstract><kwd-group xml:lang="ru"><kwd>Миоклоническая эпилепсия  с разорванными  красными волокнами</kwd><kwd>MERRF</kwd><kwd>митохондрии</kwd><kwd>миоклонус</kwd><kwd>эпилепсия</kwd><kwd>миопатия</kwd><kwd>дети</kwd></kwd-group><kwd-group xml:lang="en"><kwd>Myoclonic epilepsy  with ragged  red fibers</kwd><kwd>MERRF</kwd><kwd>mitochondria</kwd><kwd>myoclonus</kwd><kwd>epilepsy</kwd><kwd>myopathy</kwd><kwd>children</kwd></kwd-group></article-meta></front><back><ref-list><title>References</title><ref id="cit1"><label>1</label><citation-alternatives><mixed-citation xml:lang="ru">Айкарди Ж., Бакс М., Гиллберг К. (ред.) Заболевания нервной системы у детей. М.: БИНОМ; 2013: 259–360.</mixed-citation><mixed-citation xml:lang="en">Aikardi J., Bax M., Gillberg K. (Eds.) 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