potassium-bromide and stiripentol

Dravet syndrome is a catastrophic pediatric epilepsy with severe intellectual disability, impaired social development and persistent drug-resistant seizures. One of its primary monogenic causes are mutations in Nav1.1 (SCN1A), a voltage-gated sodium channel. Here we characterize zebrafish Nav1.1 (scn1Lab) mutants originally identified in a chemical mutagenesis screen. Mutants exhibit spontaneous abnormal electrographic activity, hyperactivity and convulsive behaviours. Although scn1Lab expression is reduced, microarray analysis is remarkable for the small fraction of differentially expressed genes (~3%) and lack of compensatory expression changes in other scn subunits. Ketogenic diet, diazepam, valproate, potassium bromide and stiripentol attenuate mutant seizure activity; seven other antiepileptic drugs have no effect. A phenotype-based screen of 320 compounds identifies a US Food and Drug Administration-approved compound (clemizole) that inhibits convulsive behaviours and electrographic seizures. This approach represents a new direction in modelling pediatric epilepsy and could be used to identify novel therapeutics for any monogenic epilepsy disorder.

Topics: Animals; Anticonvulsants; Benzimidazoles; Bromides; Diazepam; Dioxolanes; Drug Evaluation, Preclinical; Epilepsies, Myoclonic; Gene Expression Profiling; Mutation; NAV1.1 Voltage-Gated Sodium Channel; Potassium Compounds; Seizures; Valproic Acid; Voltage-Gated Sodium Channel beta-1 Subunit; Zebrafish; Zebrafish Proteins