Gerlach Anthony T., et al.
Journal of Parenteral and Enteral Nutrition, 2011
Abstract
Objective
In children, vitamin B(6) (pyridoxine) deficiency has been described as a cause of seizures that are refractory to conventional antiepileptic medications. We describe the clinical presentation of 3 adults with refractory seizures (later diagnosed with vitamin B(6) deficiency) that resolved after pyridoxine treatment.
Design
Case series.
Setting
Tertiary care surgical intensive care unit.
Patients
In the first case, a 54-year-old male with history of alcoholic cirrhosis developed new-onset seizures refractory to phenytoin and levetiracetam 8 days after liver transplantation. In the second case, a 59-year-old male with hepatitis C infection developed intracranial hemorrhage and new-onset seizures refractory to phenytoin, levetiracetam, and pentobarbital. The third patient is a 78-year-old male with a history of alcohol dependence who was admitted for an intraventricular bleed and developed new onset of refractory seizures.
Interventions
Intravenous pyridoxine followed by oral pyridoxine. Measurement and
Main Results
In all 3 cases, seizures persisted despite escalation of conventional antiepileptic medications but resolved within 2 days of pyridoxine supplementation. In each case, low serum pyridoxal 5'-phosphate concentrations normalized with pyroxidine administration.
Conclusions
Although refractory seizures caused by vitamin B(6) deficiency are rare in adults, it should be considered in critically ill adult patients with refractory seizures.
| PMID: | 21378258 |
|---|---|
| DOI: | 10.1177/0148607110384118 |
| Category: | Vitamins |
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