Identifying an underlying genetic cause for a patient's epilepsy can provide a clear diagnosis, inform personalized medical management, and identify at-risk relatives. EpilepsyNext-Expanded™ is a >900-gene panel design to identify genetic causes of epilepsy-related disorders, primarily with neonatal to childhood onset. Genes included are associated with epilepsy-only disorders, syndromic conditions in which seizures have been reported, as well as treatable metabolic conditions that can include seizures when undiagnosed and/or untreated. 
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Quick Reference
Test Code 6865
Turnaround Time (TAT) 6-8 weeks
Number of Genes 965

Ordering Options

We offer family variant testing at no additional cost

We offer family variant testing for all blood relatives of patients who undergo full single gene sequencing, multigene panel testing or exome sequencing at Ambry Genetics and are found to have a pathogenic or likely pathogenic variant. Testing must be completed within 90 days of the original report date. Whenever possible, more closely related relatives should be tested before more distant relatives. If you or a family member are interested in learning more about our family testing program or when family testing may be clinically indicated, please contact us or your provider for additional information. Note that Ambry can only provide such family testing services to patients receiving medical care in the U.S or US territories.

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Patient for Life Program

For patients undergoing this test, Ambry will continually review data for potential pathogenic or likely pathogenic variants in newly characterized genes and will proactively issue reclassification reports, as applicable. Ask your Genomic Science Liaison for more details.

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Why Is This Important?

Benefits of genetic testing for seizure disorders may include: 

  1. Clarifying a diagnosis and prognosis  
  2. Availability of tailored treatment options (e.g. mTOR inhibitors for TSC1/TSC2, avoid sodium channel blockers for SCN1A)
  3.  Reduction of alternative, potentially invasive testing
  4.  Identification of at-risk family members


Test Description

EpilepsyNext-Expanded evaluates >900 genes assocaited with a variety of seizure disorders. Panel content is regularly updated based on proactive review of current literature using an internal, peer-reviewed clinical validity scheme.The patient’s test report will include a list of genes evaluated. For the most up-to-date gene lists, see above.  

Ambry Genetics neurology panels are completed via whole exome capture with targeted analysis of clinically relevant gene lists.2 FMR1 repeat expansion testing is not included in this test, but can be ordered concurrently. Genomic deoxyribonucleic acid (gDNA) is isolated from the patient’s specimen using a standardized methodology and quantified. Each DNA sample is sheared, adaptor ligated, PCR-amplified and incubated with the exome baits. Captured DNA is eluted, and PCR amplified. Final quantified libraries are seeded onto an Illumina flow cell and sequenced using paired-end, 150 cycle chemistry on the Illumina HiSeq or NextSeq. 

Coding exons plus at least 6 bases into the 5’ and 3’ ends of all the introns are analyzed and reported. Gross deletion/duplication analysis is assessed for all genes within the targeted exome using a custom pipeline based on coverage (>4 exons in size) and/or breakpoint analysis from NGS data and confirmed by targeted chromosomal microarray, SNP array or MLPA when applicable. CNVs detected by NGS pipeline for which no orthogonal method of confirmation is available will not be included. Variants of uncertain significance (VUS), if present, are not routinely reported, unless the ordering provider opts-in to VUS reporting at the time of ordering.  

When familial samples are received, co-segregation analysis of potentially informative alterations will be performed, except for gross deletions/duplications which are confirmed in the proband only. Co-segregation results may be confounded by many factors which cannot be completely ruled out including reduced penetrance, age-of-onset, and/or variable expressivity. In most cases, phase cannot be determined. 

1. Smith ED, Radtke K, Rossi M, et al. 2017. Human Mutation. 38(5):600-608

2. LaDuca H, Farwell KD, Vuong H, et al., 2017. PLoS ONE 12(2):e0170843

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