Evaluation of Homocysteine, Folic Acid and Vitamin B12 Levels among Egyptian Children with Idiopathic Epilepsy

Soha M Abd El Dayem ,Manal E Kandil ,Rania H Shatla ,Sara Elgammal ,Osama N Saleh ,Nahed Emara

doi:10.3889/mjms.1857-5773.2014.0358

Abstract

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 Pearson’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.

Highlights

Vitamin B12 deficiency has been encountered amongst the benign and rare causes of infantile seizures
Serum levels of vitamin B12 were significantly higher in epileptic patients compared to the controls (p=0.03) (Table 2)
Mean serum levels of Hcy and folic acid were not significantly higher in all epileptic patients and AEDs users compared to controls

Summary

Introduction

Vitamin B12 deficiency has been encountered amongst the benign and rare causes of infantile seizures. Common symptoms of Vitamin B12 deficiency in infants include megaloblastic anemia, feeding difficulties, developmental delay, microcephaly, failure to thrive, hypotonia, lethargy, irritability, involuntary movements, seizures and cerebral atrophy [1]. On anti-epileptic drugs are prone to high concentrations of plasma homocysteine and low status of folate and Vitamin B6 [5]. Increased homocysteine and low folate status may contribute to the development of anti-epileptic drug related side effects, such as impaired cognitive function [6]. We are aiming to evaluate the relationship between the levels of homocysteine and the cofactors involved in its metabolism as folic acid and vitamin B12 with anti-epileptic drugs in epileptic patients and their role in epilepsy control.

Methods

Results

Conclusion