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Background and Purpose 22q11.2 deletion syndrome (22q11.2DS) is the most common microdeletion syndrome. Epilepsy and other neuropsychiatric (NP) manifestations of this genetic syndrome are not uncommon, but they are also not well-understood. We sought to identify the characteristics of epilepsy and other associated NP manifestations in patients with 22q11.2DS. Methods We retrospectively analyzed the medical records of 145 child and adolescent patients (72 males and 73 females) with genetically diagnosed 22q11.2DS. Te clinical data included seizures, growth chart, psychological reports, development characteristics, school performance, other clinical manifestations, and laboratory fndings. Results Of the 145 patients with 22q11.2DS, 22 (15.2%) had epileptic seizures, 15 (10.3%) had developmental delay, and 5 (3.4%) had a psychiatric illness. Twelve patients with epilepsy were classifed as genetic epilepsy whereas the remaining were classifed as structural, including three with malformations of cortical development. Patients with epilepsy were more likely to display developmental delay (odds ratio=3.98; 95% confdence interval=1.5–10.5; p=0.005), and developmental delay was more common in patients with structural epilepsy than in those with genetic epilepsy. Conclusions Patients with 22q11.2DS have a high risk of epilepsy, which in these cases is closely related to other NP manifestations. Tis implies that this specifc genetic locus is critically linked to neurodevelopment and epileptogenesis.

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