Abstract:Objective To summarize the phenotypic and genetic features of 2 cases of developmental and epileptic encephalopathy 85 (DEE85) caused by SMC1A mutations. Methods Clinical data and peripheral blood of 2 children with DEE85 were collected. The potential pathogenic genes were detected by whole exome sequencing. Results Two female children developed the frequent tonic-clonic seizure in infancy, with developmental delay and mild facial deformity. EEG showed diffuse slow wave. MRI revealed no midline brain defects. Genetic analysis uncovered de novo heterozygous variants of SMC1A gene, c.511C>T (p.Arg171Ter) and c.138_139insA (p.Phe47IlefsTer5). The seizures and developmental delay remained after treated with several antiepileptic drugs. Conclusion DEE85 caused by SMC1A mutations is X-linked dominant inheritance, and presents with infancy-onset refractory epilepsy and developmental delay.