Beschreibung:
<jats:p>We report on the rare case of a male toddler presenting with myoclonic epilepsy characterized by daily episodes of upward movements of the eyebrows, and myoclonic jerks of both head and upper limbs. In addition, the child showed speech delay, tremors, and lack of motor coordination. Next Generation Sequencing analysis (NGS) performed in trio revealed in the proband the c.889C&gt;T <jats:italic>de novo</jats:italic> missense variant in the <jats:italic>KCNA2</jats:italic> gene in heterozygous state. This is the first case of myoclonic epilepsy in a toddler due to a c.889C&gt;T <jats:italic>KCNA2</jats:italic> missense variant. The patient was treated with valproic acid and ethosuximide with a good clinical response. At 6 years old, follow-up revealed that the proband was seizure-free with tremors and clumsiness in movements. According to the literature, this case supports the correlation between myoclonic epilepsy and <jats:italic>KCNA2</jats:italic> alterations. This evidence suggests that performing genomic testing including the <jats:italic>KCNA2</jats:italic> gene in preschool patients affected by myoclonic epilepsy, especially when associated with delayed neurodevelopment. Our goal is to expand the phenotypical spectrum of this rare condition and adding clinical features following a genotype-first approach.</jats:p>