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Prolonged coma and cerebral oedema in a patient with an ATP1A2 variant

Voase, Sophie L, Fry, Andrew E ORCID: https://orcid.org/0000-0001-9778-6924 and Hamandi, Khalid 2025. Prolonged coma and cerebral oedema in a patient with an ATP1A2 variant. Practical Neurology 10.1136/pn-2025-004659

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Abstract

ATP1A2 (OMIM 182340) encodes the α2 subunit of Na+/K+-ATPase. Variation in this gene has been associated with a spectrum of clinical phenotypes, including familial hemiplegic migraine type 2 (FHM2), epilepsy and intellectual disability. A 22-year-old woman with intellectual disability, hemiplegic migraine and epilepsy presented with persistent decreased consciousness, unexplained by initial investigations. Two weeks later, repeat imaging showed new, marked cerebral oedema with no identified cause; this eventually resolved. A year later, she had a further milder episode. An epilepsy gene panel identified a likely pathogenic missense variant in the ATP1A2 gene (NM_000702.3: c.1027A>C, p.(Thr343Pro)). After starting memantine as a targeted treatment, her migraine and seizure frequency reduced. This case highlights the importance of early genetic testing in certain people with epilepsy to determine the cause and enable targeted therapeutic interventions.

Item Type: Article
Date Type: Publication
Status: In Press
Schools: Schools > Medicine
Additional Information: RRS applied 02/12/2025 AB
Publisher: BMJ Publishing Group
ISSN: 1474-7758
Date of First Compliant Deposit: 2 December 2025
Date of Acceptance: 5 November 2025
Last Modified: 02 Dec 2025 10:30
URI: https://orca.cardiff.ac.uk/id/eprint/182784

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