Evaluation of Homocysteine, Folic Acid and Vitamin B12 Levels among Egyptian Children with Idiopathic Epilepsy
Keywords:homocysteine, folic acid, vitamin B12, epilepsy.
Objective: To evaluate relationship between homocysteine (Hcy), folic acid and vitamin B12 with anti-epileptic drugs in epileptic patients and their role in epilepsy control.
Patient and Methods: The study included 60 patients with idiopathic epilepsy and thirty non-epileptic children of the same age and sex served as controls. All cases were subjected to physical and neurological examination and electroencephalogram (EEG). Serum level of folic acid, homocysteine (Hcy) and vitamin B12 were done for both epileptic patients and controls. Non parametric test, one way ANOVA and Pearsonâ€™s correlation were used for analysis of data.
Result: 44 patients (73.3%) had generalized epilepsy and the remaining patients had partial epilepsy (simple or complex). 37 patients (61.6%) were in grade I, 3 patients (5 %) were in grade II and the remaining 20 patients (33.3 %) were in grade III epilepsy. Vitamin B12 was significantly higher in epileptic patients. Duration of anti-epileptic drug treatment was correlated significantly to folic acid and Hcy level.Conclusion: antiepileptic drugs might upset the homeostatic balance of Hcy and its cofactors and cause abnormalities of their serum levels. The duration of anti-epileptic drug treatment was related to decrease of folic acid and increase in homocysteine levels.
Benbira G, Uysalb S, Saltikc S, Aktuglu Zeybekd C, A Aydind A, Derventa A and Yalcinkayaa C. Seizures during treatment of Vitamin B12 deficiency. Euro J Epilepsy. 2007; 16(1): 69-73.
Reynolds EH. Benefits and risks of folic acid to the nervous system. J Neurol Neurosurg Psychiatry. 2002; 72: 567-571.
Lewis DP, Van Dyke DC, Willhite LA: Phenytoin-folic acid interaction. Ann Pharmacother 1995; 29:726-735.
Mares P, Folbergrova J, Langmeier M, Haugvicova R and Kubova H. Convulsant action of d,l-homocysteic acid and its stereoisomers in immature rats. Epilepsia. 1997; 38:767â€“776.
Vilaseca MA, Monros E, Arthuch R. Anti-epileptic drug treatment in children: T mutation of the hyper homocysteinemia. B vitamins and the 667C methyleneterahydrofolate reductase gene. Eur J Paediatr Neurol. 2000; 41:269-277.
Loring DW and Meador KJ. Cognitive side effects of anti epileptic drugs in children. Neurology. 2004; 62:872-877.
Guidelines for epidemiologic studies on epilepsy. Commission on Epidemiology and Prognosis, International League Against Epilepsy. Epilepsia. 1993;34(4):592-6.
International League against Epilepsy Revised Classification of Epileptic Seizures, 1981.
Duncan and Sander JW. Chalfont seizures severity score. J Neurol Neurosurg Psychaitry. 1991; 54(10):873-876.
Stern JM and Engel J. Categorization by pattern features. Atlas of EEG patterns. Lippincott Williams and Wilkins, 2005: 13-25.
Schwaninger M, Ringleb P, Winter R, Kohl B, Fiehn W, Rieser PA, Walter-Sack I. Elevated plasma concentrations of homocysteine in antiepileptic drug treatment. Epilepsia. 1999; 40(3):345-350.
Senera U, Zorlua Y, Karaguzela O, Ozdamarb O, Cokerb I and Topbasc M. Effects of common anti-epileptic drug monotherapy on serum levels of homocysteine, Vitamin B12, folic acid and Vitamin B6. British Epilepsy Association. 2006; 15(2):79-85.
Aslan K, Bozdemir H, Unsal C and Guvenc B. The effect of antiepileptic drugs on vitamin B12 metabolism. International Journal of Laboratory Hematology. 2008; 30: 26-35.
Tamura T, Aiso K, Johnston KE, Black L and Faught E. Homocysteine, folate, vitamin B12 and vitamin B6 in patients receiving antiepileptic drug monotherapy. Epilepsy Res. 2000; 40:7â€“15.
Karabiber H, Sonmzgoz E, Ozerol E, Yakinci C, Otlu B and Yologlu S. Effects of valproate and carbamazepine on serum levels of homocysteine, vitamin B12 and folic acid. Brain Development. 2003; 25:113â€“115.
Dastur DK and Dave UP. Effect of prolonged anticonvulsant medication in epileptic patients: serum lipids, vitamins B6, B12, and folic acid, proteins, and fine structure of liver. Epilepsia. 1987; 28:147-159.
Frank O, Baker H and Leavy CM. Vitamin binding capacity of experimentally injured liver. Nature. 1964; 203: 302-303.
Cardo E, Vilaseca MA, Campistol J, Artuch R, ColomÃ© C, Pineda M. Evaluation of hyperhomocysteinemia in children with stroke. Eur J Paediatr Neurol. 1999; 3: 113-117.
Huemer M, Ausserer B, Graninger G, Hubmann M, Huemer C, Schlachter K, Tscharre A, Ulmer H, Simma B. Hyperhomocysteinemia in children treated with antiepileptic drugs is normalized by folic acid supplementation. Epilepsia. 2005; 46:1677-1683.
Kishi T, Fujita N, Eguchhi T and Ueda K. Mechanism for reduction of serum folate by antiepileptic drugs during prolonged therapy. J Neurol Sci. 1997; 145: 109-112.
Verrotti A, Pascarella R, Trotta D, Giuva T, Morgese G and Chiarelli F. Hyperhomocysteinemia in children treated with sodium valporate and carbamazepine. Epilepsy Res. 2000; 41:253-257.
Ono H, Sakamoto A, Mizoguchi N and Sakura N. The C677T mutation in the methylenetetrahydrofolate reductase gene contributes to hyperhomocysteinemia in patients taking anticonvulsants. Brain Dev. 2002; 24:223â€“226.
Vurucu S, Demirkaya E, Kul M, Unay B, Gul D, Akin R, GokÃ§ay E. Evaluation of the relationship between C677T variants of methylenetetrahydrofolate reductase gene and hyperhomocytsteinemia in children receiving antiepileptic drug therapy. Progress in Neuro-Psychopharmacology and Biological Psychiatry. 2008; 23: 844-848.
Gidal BE, Tamura T, Hammer A, Vuong A. Blood homocysteine, folate and vitamin B-12 concentrations in patients with epilepsy receiving lamotrigine or sodium valproate for initial monotherapy. Epilepsy Res. 2005;64(3):161-6.
Geda G, Caksen H and Icagasioglu D. Serum lipids, vitamin B12 and folic acid levels in children receiving long-term valproate therapy. Acta Neurol Belg. 2002; 102: 122-126.
Apeland T, Mansoor MA and Strandjord RE. Antiepileptic drugs as independent predictors of plasma total homocysteine levels. Epilepsy Res. 2001; 47:27â€“35.
Kurul S, Unalp A and Yis U. Homocysteine levels in epileptic children receiving antiepileptic drugs. J Child Neurol. 2007; 22(12): 1389-1392.
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