Test Code EPPAN Comprehensive Epilepsy With or Without Encephalopathy Gene Panel, Varies
Ordering Guidance
Customization of this panel and single gene analysis for any gene present on this panel is available. For more information see CGPH/ Custom Gene Panel, Hereditary, Next-Generation Sequencing, Varies.
Targeted testing for familial variants (also called site-specific or known variant testing) is available for the genes on this panel. See FMTT / Familial Variant, Targeted Testing, Varies.
Shipping Instructions
Specimen preferred to arrive within 96 hours of collection.
Specimen Required
Patient Preparation: A previous bone marrow transplant from an allogenic donor will interfere with testing. Call 800-533-1710 for instructions for testing patients who have received a bone marrow transplant.
Specimen Type: Whole blood
Container/Tube:
Preferred: Lavender top (EDTA) or yellow top (ACD)
Acceptable: Any anticoagulant
Specimen Volume: 3 mL
Collection Instructions:
1. Invert several times to mix blood.
2. Send whole blood specimen in original tube. Do not aliquot.
Specimen Stability Information: Ambient (preferred)/Refrigerated
Forms
1. New York Clients-Informed consent is required. Document on the request form or electronic order that a copy is on file. The following documents are available:
-Informed Consent for Genetic Testing (T576)
-Informed Consent for Genetic Testing (Spanish) (T826)
2. Molecular Genetics: Neurology Patient Information
3. If not ordering electronically, complete, print, and send a Neurology Specialty Testing Client Test Request (T732) with the specimen.
Secondary ID
616550Useful For
Establishing a diagnosis of an epilepsy or seizure disorder associated with known causal genes
Identifying disease-causing variants within genes known to be associated with inherited epilepsy or seizure disorders, allowing for predictive testing of at-risk family members
Impacting patient treatment and management through the identification of a specific underlying etiology for epilepsy (eg, directing appropriate use of antiepileptic drugs and other treatment modalities)
Special Instructions
- Informed Consent for Genetic Testing
- Molecular Genetics: Neurology Patient Information
- Epilepsy: Unexplained Refractory and/or Familial Testing Algorithm
- Informed Consent for Genetic Testing (Spanish)
- Targeted Genes and Methodology Details for Comprehensive Epilepsy With or Without Encephalopathy Gene Panel
Method Name
Sequence Capture and Targeted Next-Generation Sequencing followed by Polymerase Chain Reaction (PCR) and Sanger Sequencing
Reporting Name
Comprehensive Epilepsy Gene PanelSpecimen Type
VariesSpecimen Minimum Volume
1 mL
Specimen Stability Information
Specimen Type | Temperature | Time | Special Container |
---|---|---|---|
Varies | Varies |
Reject Due To
All specimens will be evaluated by Mayo Clinic Laboratories for test suitability.Clinical Information
Epilepsy is a chronic neurological disorder characterized by recurrent and unprovoked seizures. Epilepsy is common, impacting just over 1% of the population. The underlying cause of epilepsy is multifactorial, with both genetic and nongenetic etiologies.
Inherited forms of epilepsy may present with varying seizure types, age of onset, comorbidities and underlying molecular causes, including channelopathies, metabolic conditions, and disorders associated with structural brain anomalies. Different hereditary epilepsies may follow autosomal dominant, autosomal recessive, or X-linked patterns of inheritance, or may occur as a result of a de novo pathogenic variant; therefore, identification of a specific molecular cause is essential to assess recurrence risk and impact to at risk family members.
Clinical diagnoses can be challenging as pathogenic variants in different genes may be associated with strikingly similar clinical presentations. Comprehensive diagnostic genetic testing is useful to determine the molecular etiology which in turn can assist in establishing long-term prognosis and identifying appropriate therapeutic and management strategies.
Reference Values
An interpretive report will be provided.
Interpretation
All detected variants are evaluated according to American College of Medical Genetics and Genomics (ACMG) recommendations.(1) Variants are classified based on known, predicted, or possible pathogenicity and reported with interpretive comments detailing their potential or known significance.
Reference values for CSTB repeat expansion assay
Normal: <5 dodecamer repeats
Repeat Size of Uncertain Significance: 5-29 dodecamer repeats
Full Penetrance Expansion: >29 dodecamer repeats
Method Description
Next-generation sequencing (NGS) and/or Sanger sequencing are performed to test for the presence of variants in coding regions and intron/exon boundaries of the genes analyzed, as well as some other regions that have known disease-causing variants. The human genome reference GRCh37/hg19 build was used for sequence read alignment. At least 99% of the bases are covered at a read depth over 30X. Sensitivity is estimated at above 99% for single nucleotide variants, above 94% for deletions-insertions (delins) less than 40 base pairs (bp), above 95% for deletions up to 75 bp and insertions up to 47 bp. NGS and/or a polymerase chain reaction (PCR)-based quantitative method is performed to test for the presence of deletions and duplications in the genes analyzed. Additionally, a combined amplicon-length and repeat-primed PCR-based assay is utilized to detect expansions of a dodecamer repeat region in the CSTB gene.
There may be regions of genes that cannot be effectively evaluated by sequencing or deletion and duplication analysis as a result of technical limitations of the assay, including regions of homology, high guanine-cytosine (GC) content, and repetitive sequences. See Targeted Genes and Methodology Details for the Comprehensive Epilepsy with or without Encephalopathy Gene Panel for details regarding the specific gene regions not routinely covered.(Unpublished Mayo method)
Genes analyzed: ABAT, ACO2, ACY1, ADARB1, ADGRG1, ADSL, AFG3L2, AIFM1, AKT2, ALDH3A2, ALDH5A1, ALDH7A1, ALG13, AMT, AP2M1, APOPT1 (COA8), ARFGEF2, ARHGEF9, ARX, ASAH1, ASNS, ATN1, ATP1A2, ATP1A3, ATRX, BCKDK, BCS1L, BOLA3, BRAT1, C12orf57, CACNA1A, CACNA1E, CACNA2D2, CAD, CARS2, CASK, CCM2, CDKL5, CHD2, CHRNA2, CHRNA4, CHRNB2, CLCN4, CLN3, CLN5, CLN6, CLN8, CNTNAP2, COA8 (APOPT1), COG7, COG8, COL18A1, COL4A1, COQ2, COQ4, COQ6, COQ8A, COQ9, COX10, COX15, CPT2, CSF1R, CSTB, CTSD, CTSF, CUL4B, D2HGDH, DCX, DDC, DDX3X, DEPDC5, DHFR, DIAPH1, DLD, DMXL2, DNAJC5, DNM1, DNM1L, DOCK7, DYRK1A, EARS2, EEF1A2, EHMT1, EIF2AK2, EPM2A, ETHE1, FARS2, FASTKD2, FBP1, FBXL4, FH, FKRP, FKTN, FLNA, FOLR1, FOXG1, FOXRED1, FRRS1L, GABBR2, GABRA1, GABRB2, GABRB3, GABRG2, GAMT, GATM, GCK, GFM1, GLDC, GLRA1, GLUL, GNAO1, GOSR2, GPAA1, GPC3, GPHN, GRIA3, GRIN1, GRIN2A, GRIN2B, GYS2, HCFC1, HCN1, HIBCH, HNRNPU, HSD17B10, IARS2, IBA57, IDH2, IER3IP1, IQSEC2, ITPA, KANSL1, KCNA1, KCNA2, KCNB1, KCNC1, KCNH1, KCNJ10, KCNMA1, KCNQ2, KCNQ3, KCNT1, KCTD7, KDM5C, KDM6A, KRIT1, L2HGDH, LAMA2, LARGE1, LGI1, LIAS, LRPPRC, MBD5, MECP2, MEF2C, MFSD8, MICU1, MOCS1, MOCS2, MTFMT, MTO1, MTOR, NALCN, NDUFA1, NDUFA2, NDUFAF2, NDUFAF3, NDUFAF4, NDUFAF5, NDUFAF6, NDUFS1, NDUFS4, NDUFS6, NDUFS7, NDUFS8, NDUFV1, NECAP1, NEDD4L, NEU1, NEXMIF, NGLY1, NHLRC1, NOTCH3, NPRL2, NPRL3, NR2F1, NR4A2, NRROS, NRXN1, OCLN, OFD1, OPHN1, OTUD6B, P4HTM, PACS1, PACS2, PAFAH1B1, PAK3, PCDH12, PCDH19, PDCD10, PDHA1, PDHB, PDHX, PDP1, PDSS2, PEX7, PHF6, PHGDH, PIGA, PIGG, PIGK, PIGL, PIGM, PIGN, PIGO, PIGQ, PIGS, PIGT, PIGU, PIGV, PIGW, PLCB1, PLP1, PLPBP, PNKP, PNPLA8, PNPO, POLG, POMGNT1, POMT1, POMT2, PPP2R5D, PPT1, PRRT2, PURA, QARS1, RAB39B, RAB3GAP1, RALA, RALGAPA1, RANBP2, RARS2, RELN, RMND1, ROGDI, RRM2B, SATB2, SCARB2, SCN1A, SCN1B, SCN2A, SCN3A, SCN8A, SCO2, SDHAF1, SERAC1, SERPINI1, SETBP1, SETD2, SIK1, SLC12A5, SLC13A5, SLC16A1, SLC19A3, SLC25A1, SLC25A12, SLC25A22, SLC2A1, SLC35A2, SLC35A3, SLC6A1, SLC6A8, SLC9A6, SMARCA2, SMC1A, SMS, SNAP25, SNAP29, SNX27, SPATA5, SPR, SPTAN1, ST3GAL3, ST3GAL5, STRADA, STX1B, STXBP1, SUCLA2, SUOX, SYN1, SYNGAP1, SYNJ1, SYP, SZT2, TBC1D24, TBL1XR1, TCF4, TPK1, TPP1, TSC1, TSC2, TSFM, TUBA1A, TUBA8, TUBB2B, TWNK, UBE3A, UGP2, USP7, VARS2, VLDLR, WDR26, WDR37, WDR45, WDR62, WWOX, YWHAG, ZDHHC9, and ZEB2
Day(s) Performed
Varies
Performing Laboratory
Mayo Clinic Laboratories in RochesterTest Classification
This test was developed and its performance characteristics determined by Mayo Clinic in a manner consistent with CLIA requirements. It has not been cleared or approved by the US Food and Drug Administration.CPT Code Information
81419
LOINC Code Information
Test ID | Test Order Name | Order LOINC Value |
---|---|---|
EPPAN | Comprehensive Epilepsy Gene Panel | In Process |
Result ID | Test Result Name | Result LOINC Value |
---|---|---|
616551 | Test Description | 62364-5 |
616552 | Specimen | 31208-2 |
616553 | Source | 31208-2 |
616554 | Result Summary | 50397-9 |
616555 | Result | 82939-0 |
616556 | Interpretation | 69047-9 |
616557 | Resources | 99622-3 |
616558 | Additional Information | 48767-8 |
616559 | Method | 85069-3 |
616560 | Genes Analyzed | 82939-0 |
616561 | Disclaimer | 62364-5 |
616562 | Released By | 18771-6 |
Testing Algorithm
For more information see Epilepsy: Unexplained Refractory and/or Familial Testing Algorithm