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March 26, 2014: Vitamin B6 and Epilepsy

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March 26, 2014

Pyridoxine, or Vitamin B6 is a cofactor and essential for amino acid metabolism and neurotransmitter synthesis. It can be found in a variety of foods including nuts and vegetables. Deficiency of pyridoxine results in a syndrome of dermatitis, glossitis, and neurologic chances including neuropathy and seizures. In children, pyridoxine-dependent epilepsy presents in the neonatal or early infantile period with intractable seizures, but can present up to three years of age [1]. Administration of pyridoxine can result in immediate or delayed response over several days; responders require lifelong supplementation. In adults, pyridoxine-deficiency is associated with isoniazid toxicity, dietary restriction, and critical illness [2]. It can be suspected in adults for whom conventional anti-epileptic trials fail.

References

  1. Stockler, Sylvia, et al. Pyridoxine dependent epilepsy and antiquitin deficiency: Clinical and molecular characteristics and recommendations for diagnosis, treatment and follow-up. Mol Genet Metab; 2011; 104: 48-60.
  2. Gerlach, Anthony, et al. Vitamin B6 Deficiency. A potential cause of refractory seizures in adults. Curr Opin Pediatr 2011; 35: 272-275.

Submitted by: Adam Numis, MD 
Dr. Numis is a member of the Resident and Fellow Section of Neurology

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