Abstract
The relationship between increased homocysteine (Hcy) level and epileptic seizure remains controversial in human, despite a growing evidence of the pro-convulsive effect of the hyperhomocysteinemia (HHcy) observed in the animal studies. The mechanism of this association with epileptogenesis has not been clearly understood, although there is emerging evidence to support the unfavorable effects of some anti-epileptic drugs (AEDs) on the plasma homocysteine (Hcy) concentrations. The aim of this study was to uncover the relationship between the levels of homocysteine (Hcy), the cofactors involved in its metabolism as folic acid and vitamin B12 and anti-epileptic drugs (AEDs) in epileptic patients. Serum level of homocysteine (Hcy), folic acid and vitamin B12 was measured in 60 patients with idiopathic epilepsy; and its level was compared to 30 healthy children serving as control group. No significant difference was found regarding the plasma homocysteine (Hcy) levels between patients (both receiving anti-epileptics and non anti-epileptic drug users) and controls. Epileptic patients on polytherapy showed higher mean serum levels of homocysteine (Hcy) and lower mean serum levels of folic acid compared to those on monotherapy. However, the mean serum levels of homocysteine (Hcy), vitamin B12 and folic acid showed non significant differences between patients using valproic acid (VPA) or carbamazepine (CBZ). Duration of AED therapy showed a significant positive correlation with mean serum levels of homocysteine (Hcy) and a significant negative correlation with mean serum levels of folic acid. To conclude; AEDs upset the homeostatic balance of homocysteine (Hcy) and its cofactors and cause abnormalities in their serum levels.
Highlights
Homocysteine (Hcy), is a sulfur-containing amino acid that is formed by de-methylation of methionine [1]
Our study showed that the mean serum levels of Hcy and folic acid showed non significant differences between epileptic patients and the controls (p = 0.07, p = 0.6, respectively)
The mechanism of the association between homocysteine and epilepsy is not fully understood, it is recommended that anti-epileptic drugs (AEDs) increase serum Hcy by decreasing the blood folate levels, due to antifolate properties, and depletion of other vitamins like B2 and B6 [19,20]
Summary
Homocysteine (Hcy), is a sulfur-containing amino acid that is formed by de-methylation of methionine [1]. Plasma Hcy concentrations vary with ethnic background, increase with age, are higher in adult men and postmenopausal women, and lowest in children [2]. It has been reported that Hcy induces neuronal cell death by stimulating N-methyl D aspartate (NMDA) receptors mediating excitotoxicity, as well as by producing free radicals [6] and induction of apoptosis [7]. Homocysteic acid and L-Hcy sulfinic acid, exhibit high excitotoxic potency by interacting with different glutamate receptor subtypes [8]. They are potent agonists of the NMDA-type glutamate receptor, which are linked with epileptogenesis [9]
Sign-in/Register to view highlights & summary Talk to us
Join us for a 30 min session where you can share your feedback and ask us any queries you have
Schedule a callDisclaimer: All third-party content on this website/platform is and will remain the property of their respective owners and is provided on "as is" basis without any warranties, express or implied. Use of third-party content does not indicate any affiliation, sponsorship with or endorsement by them. Any references to third-party content is to identify the corresponding services and shall be considered fair use under The CopyrightLaw.
