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Pathogenic  FLNA  variants can be identified in patients with seizures accompanied by periventricular nodular heterotopia (PVNH). It is unusual to find  FLNA  aberrations in epileptic patients without PVNH on brain imaging. We report a boy with cryptogenic West syndrome followed by refractory seizures and psychomotor delay. We performed whole-exome sequencing and identified a de novo missense variant in  FLNA . It is noteworthy that this patient showed no PVNH. As no other pathogenic variants were found in epilepsy-related genes, this  FLNA  variant likely caused West syndrome but with no PVNH.

Hemizygous FLNA variant in West syndrome without periventricular nodular heterotopia