Migraine Subpanel (7)
Related Genes: ATP1A2, CACNA1A, NOTCH3, POLG, PRRT2, SCN1A, SLC2A1
Migraines can cause severe throbbing pain or a pulsing sensation. It can be accompanied by nausea, vomiting, and extreme sensitivity to light and sound. Migraines are common in people with epilepsy. Epilepsy is a neurological condition that is characterized by recurrent, unprovoked seizures. Individuals with epilepsy may also develop other neurological problems as a result of recurrent seizures. Both migraines and epilepsy are characterized by episodes of neurologic dysfunction, accompanied by headache, gastrointestinal, autonomic, and psychological manifestations. They can precede or succeed each other or occur simultaneously. The clinical presentation may overlap and be difficult for diagnosis.
The Migraine Subpanel includes 7 genes that are associated with hereditary forms of migraines. All genes on the Migraine Subpanel are also found on the Comprehensive Epilepsy Panel (226 genes). For some of the conditions, migraines may be a part of a more complex genetic syndrome with other characteristics. The disorders included in this panel may be inherited in an autosomal dominant (AD) or autosomal recessive (AR) manner.
Clinical Utility: Genetic testing of an individual may be indicated to distinguish hereditary disorders from acquired (non-genetic) causes, provide information on the likelihood of related health issues, guide clinical management, and establish disease risk to other family members and future generations.
Methods: The Migraine Sub-Panel offered by Sema4 primarily utilizes next-generation sequencing (NGS) to identify variants within the genes analyzed. Copy number variant (CNV) detection by NGS is also utilized to increase diagnostic yield. Supplemental and confirmatory technology used in this panel may include targeted genotyping, multiplex ligation-dependent probe amplification (MLPA), exon array, quantitative PCR, and Sanger sequencing. Ultra high-resolution medical exon array (UHRMEA) is available for deletion/duplication studies of gene(s) within this panel as either reflex (add-on), concurrent, or standalone test. UHRMEA provides single exon level coverage for the majority of the exons within this panel. Variant classification and interpretation are performed based on the American College of Medical Genetics Standards and guidelines for the interpretation of sequence variants.
A high-resolution chromosomal microarray (HRP) is available as an additional test, which is to identify DNA copy number variants (CNVs) associated with chromosome imbalances including gains and losses throughout the genome, as well as absence of heterozygosity (AOH) that can be indicative of uniparental disomy (UPD) or regions of the genome identical by descent (IBD).
Targeted Testing: Targeted familial mutation analysis or single gene testing is available for any of the genes on this panel. Prenatal diagnosis is also available for known familial variants; please contact our laboratory at 800-298-6470 to discuss prior to sending any prenatal samples.
Postnatal blood samples:
2 yellow-top (ACD-A or ACD-B) or 2 lavender-top (EDTA) tubes, 5-10 mL of blood from the patient are required. One blood tube from both parents is requested.
1 yellow-top (ACD-A or ACD-B) or 1 lavender-top (EDTA) tube, 2 mL of blood from the patient are required. Additionally, 1 yellow-top (ACD-A or ACD-B) or 1 lavender-top (EDTA) 5-10 mL tube of blood from both parents is requested.
Please inquire with lab (800-298-6470 option 2)
Prenatal testing for a known familial variant:
- Two confluent T-25 flasks of cultured cells from amniotic fluid or chorionic villi
- >4 mg of direct chorionic villi tissue
- 15 mL of direct amniotic fluid
- 5-10 mL of blood in an EDTA tube (lavender top) is required from each biological parent. Parental blood samples may be used for maternal cell contamination studies or confirmation studies.
- Send in previous report of known familial variant with specimen
- A minimum of 10 μL DNA (50-250 ng/μL) is required for testing. 20 μL DNA (50-350 ng/μL) is recommended
- Saliva specimens are accepted upon request. Please contact our laboratory to obtain saliva kits
- Saliva samples should be collected in Oragene DNA (OG-500) kits by DNA Genotek
- 1 cheek swab specimen collected from ORAGENE kit from the patient is required. 1 cheek swab specimen collected from ORAGENE kit from both parents is requested.
Samples should be kept and shipped refrigerated or at room temperature. Do not freeze specimens.
Include the following with each sample:
- Completed and signed test requisition form and informed consent
- Billing information or payment (include copy of insurance card)
- Contact information for referring physician
- Testing to be performed
- Indication for testing, patient’s family history, ethnic background and prior relevant test results
Send same day or overnight (check for morning delivery) to:
62 Southfield Ave
Stamford, CT 06902
Results are reported in 3-4 weeks (for postnatal samples) from the receipt of the specimen.