Genetics and genetic diagnosis of focal childhood epilepsy

Self-limiting focal epilepsies are among the most common forms of epilepsy in children. Based on family studies, a genetic basis is assumed for the epilepsy as well as the typical electroencephalographic (EEG) feature of centrotemporal spikes, although complex inheritance and possibly additional influencing factors must be considered. Variants in GRIN2A, encoding the GluN2A subunit of the N‑methyl-D-aspartate (NMDA) glutamate receptor, represent the most important genetic risk factor to date. With memantine for variants with a gain-of-function effect and L‑serine for loss-of-function variants, two personalized therapeutic approaches are potentially available. Their effectiveness and significance need to be clarified in further investigations and clinical trials.