vitamin-b-12 and Seizures

Topics: Acridines; Administration, Oral; Antipsychotic Agents; Butyrophenones; Central Nervous System Diseases; Dopamine; Humans; Molindone; Phenothiazines; Phytotherapy; Piperazines; Plants, Medicinal; Rauwolfia; Schizophrenia; Seizures; Structure-Activity Relationship; Tetrabenazine; Thioxanthenes; Tranquilizing Agents; Vitamin B 12

Topics: Adolescent; Adult; Amino Acid Metabolism, Inborn Errors; Animals; Biopsy; Carbon Radioisotopes; Child; Child, Preschool; Diet Therapy; Female; FIGLU Test; Histidine; Histidine Ammonia-Lyase; Humans; Infant, Newborn; Intellectual Disability; Liver; Male; Phenytoin; Rats; Seizures; Skin; Speech Disorders; Transferases; Urocanate Hydratase; Vitamin B 12

Topics: Anticonvulsants; Blood-Brain Barrier; Clinical Trials as Topic; Epilepsy; Folic Acid; Folic Acid Deficiency; Humans; Phenobarbital; Phenytoin; Primidone; Seizures; Tetrahydrofolates; Vitamin B 12

Topics: Anticonvulsants; Blood-Brain Barrier; Clinical Trials as Topic; Epilepsy; Folic Acid; Folic Acid Deficiency; Humans; Phenobarbital; Phenytoin; Primidone; Seizures; Tetrahydrofolates; Vitamin B 12

In Norway, 5-10% of neonates and infants have biomarkers suggesting vitamin B12 deficiency from newborn screening tests and unselected clinical screening, respectively.. The aims were to identify risk factors and describe presenting symptoms and biochemical profiles in infants diagnosed with vitamin B12 deficiency.. In this case-control study, we searched hospital medical records for infants younger than one year born in 2011-2018, diagnosed with vitamin B12 deficiency. We compared 85 cases with a control group of 252 infants aged 3-7 months. Parents completed questionnaires.. Of the 85 cases with vitamin B12 deficiency, 80% presented with spells (37%) of apneas, motor seizures, or absences within the first two months of life. Tremor (29%) and irritability (18%) were the most common findings at the first examination. Serum total homocysteine ≥10 μmol/L was found in 77% of cases compared to 28% of controls (P < 0.001). None of the mothers were vegetarians, but 25% reported a previous history of vitamin B12 deficiency and 7% had celiac disease. The dose of nitrous oxide given during labor was significantly associated with infant serum total homocysteine level at diagnosis (r = 0.37, 95% confidence interval = 0.16-0.55, P < 0.001) for cases, but not for controls.. Spells, tremor, and irritability are common findings in early infant vitamin B12 deficiency. Nitrous oxide given during labor is proposed as a contributing risk factor to the development of early infant vitamin B12 deficiency.

Topics: Breast Feeding; Case-Control Studies; Child; Female; Homocysteine; Humans; Infant; Infant, Newborn; Nitrous Oxide; Seizures; Tremor; Vitamin B 12; Vitamin B 12 Deficiency

A high throughput and high sensitive online solid phase extraction coupled to high performance liquid chromatography-tandem mass spectrometry method was established and validated for simultaneous quantification of four cobalamins including OHCbl, CNCbl, AdoCbl and MeCbl in rat plasma. Analytes were first enriched on an online SPE Shim-pack MAYI-ODS column and then separated using a Poroshell 120 EC C18 analytical column. The linear range was from 0.05 to 5 ng/ml and the LLOQ was 0.05 ng/ml for all four cobalamins. In addition, this method was applied to determine the cobalamins levels in pentylenetetrazole-induced kindling rat model for the first time.

Topics: Animals; Chromatography, High Pressure Liquid; Pentylenetetrazole; Rats; Rats, Sprague-Dawley; Seizures; Solid Phase Extraction; Tandem Mass Spectrometry; Vitamin B 12

The aim of this study was to investigate possible associations between MTHFR polymorphism and seizure control of epileptic patients with hyperhomocysteinaemia.. A total of 81 epileptic patients with hyperhomocysteinaemia treated with oxcarbazepine monotherapy were enrolled in this study. All patients were offered vitamin B supplementation (2.5 mg/d folate and 1.5 mg/d mecobalamine) for six months. MTHFR C677T and A1298C polymorphisms, serum homocysteine, folate and vitamin B12 levels as well as seizure frequency and score based on the Hamilton depression scale (HAMD) were evaluated at baseline and after six months of follow-up.. Spearman correlation analysis showed that the extent of decline of seizure frequency positively correlated with a dynamic change in serum homocysteine concentration between baseline and after six months of follow-up (t=0.241, p=0.015 [Spearman’s coefficient]). For the MTHFR C677T polymorphism, compared to the CC genotype, the TT genotype was associated with a significant downtrend of homocysteine (19.69 vs 10.28 mmol/L, p=0.006) and uptrend of folate (6.21 vs 2.49 ng/mL; p=0.004). The decrease in homocysteine (17.94 vs 12.52 mmol/L, p=0.001) and increase of folate (5.08 vs 2.86 ng/mL; p=0.003) were significantly greater in patients with the T allele compared to those with the C allele. Also, the TT genotype (2.33 vs 1.4, p=0.056) and T allele (1.95 vs 1.38, p=0.037) were associated with a greater decrease in seizure frequency compared to the CC genotype or C allele. The A1298C polymorphism alone was not associated with elevated homocysteine or decreased folate levels at baseline, and showed little association with response to vitamin B supplementation in epileptic patients with hyperhomocysteinaemia. However, in patients with combined 677TT/1298AA or 677TT/1298AC polymorphisms, the changes in homocysteine and folate levels and seizure frequency were more obvious.. MTHFR C677T polymorphism was associated with seizure control in epileptic patients with hyperhomocysteinaemia; individuals with the 677TT genotype or T allele demonstrated better seizure control.

Topics: Epilepsy; Folic Acid; Genotype; Homocysteine; Humans; Methylenetetrahydrofolate Reductase (NADPH2); Polymorphism, Genetic; Seizures; Vitamin B 12; Vitamins

Cerebral venous thrombosis is relatively rare and characterized by a wide spectrum of clinical features. It is more common in young adults with women affected more than men. The diagnosis of cerebral venous thrombosis is easier nowadays due to easy access to advanced neuroimaging techniques. Abnormalities in thrombophilic profile are associated with enhanced risk of cerebral venous thrombosis. It has varied etiologies such as hypercoagulable states, infection, dehydration, pregnancy, and substance abuse. Hyperhomocysteinemia is found to be closely associated with an enhanced risk of cerebral venous thrombosis.. Here we report a case of cerebral venous thrombosis secondary to hyperhomocysteinemia caused by vitamin B. There are conflicting reports in the literature about the association of hyperhomocysteinemia, B

Topics: Adult; Anticoagulants; Anticonvulsants; Brain; Diuretics, Osmotic; Glycerol; Heparin; Humans; Hyperhomocysteinemia; Intracranial Thrombosis; Magnetic Resonance Imaging; Male; Mannitol; Seizures; Valproic Acid; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex; Warfarin

Vitamin B

Topics: Anemia, Pernicious; Delayed Diagnosis; Dementia; Female; Humans; Middle Aged; Psychotic Disorders; Seizures; Vitamin B 12; Vitamin B Complex

The aetiology spectrum for neuroregression in infants and toddlers is diverse. Vitamin B12 deficiency-mediated neuroregression is less commonly considered as a differential. Prevalence of pernicious anaemia in the general population is 0.1% and is extremely rare in children. We describe a 35-month-old toddler with neuroregression, seizures, coarse tremors, bleating cry and neuropathy. His clinical symptomatology mimicked grey matter degenerative illness and infantile tremor syndrome, a nutritional deficiency-mediated movement disorder. His vitamin B12 level was low and serum homocysteine level was elevated. Haematological manifestations were not overt and anti-intrinsic factor antibody was positive. With parenteral vitamin B12 therapy, there was a dramatic response with clinical and laboratory translation. This report emphasises the need for a high index of suspicion and screening for markers of vitamin B12 deficiency in all children with unexplained acute or subacute neuroregression, seizures and movement disorders as it is potentially reversible.

Topics: Anemia, Pernicious; Child, Preschool; Developmental Disabilities; Drug Therapy, Combination; Dyskinesias; Humans; Male; Seizures; Tremor; Vitamin B 12; Vitamin B Complex

Topics: Atrophy; Developmental Disabilities; Female; Fever; Homocysteine; Humans; Infant; Muscle Hypotonia; Neuroimaging; Seizures; Vitamin B 12; Vitamin B 12 Deficiency

This report highlights a rare presentation of vitamin B(12) deficiency (concurrent psychotic disorder, seizures and hypertension). A 16-year-old girl presented with nervousness that had been persisting for 2 weeks. She had stopped eating and there was decreased self-care and she could not walk and sleep. Two days prior to admission, generalized tonic-clonic convulsions were noted. On physical examination, vital signs were normal, except for hypertension (150/100 mm Hg). She did not respond to conversation; she could not answer the questions. Mood was depressive and hallucinations were noted. Laboratory analyses were normal, except for a low vitamin B(12) level (<150 pg mL(-1)). The patient was not given any treatment of hypertension, psychosis or seizures, except vitamin B(12) injections. After that, she showed improvement within 1 week. In the 7 days of hospitalization, the arterial blood pressure returned to normal, psychotic symptoms were resolved, the visual hallucinations and the depressive mood subsided, and she could eat and speak clearly. No hypertension or convulsions have been detected on the control examinations, and she has now been followed-up without any symptoms or findings. In conclusion, with this report we emphasized that psychosis, seizures and hypertension can be a rare manifestation of vitamin B(12) deficiency, which is reversible with therapy and serum vitamin B(12) level should be checked in patients who do not have an obvious cause for psychosis, seizures or hypertension.

Topics: Adolescent; Female; Humans; Hypertension; Psychotic Disorders; Seizures; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency

The incidence of seizures is generally accepted to be greater in patients with multiple sclerosis (MS) than in the general population, and rarely, MS can initially present as seizure. To present a case report of seizure as the initial symptom of MS, to quantify the occurrence of seizures among MS patients, and to classify patients according to when seizures occur relative to onset of MS. The medical history of patients presenting with MS and seizure in our clinic was examined. In addition, 25 scientific papers were reviewed and the number and characteristics of patients with MS and seizure recorded. Data from the literature review and from our own clinical series were combined and examined. Of the MS patients, 1.95% experienced seizures at any time during life. Patients experiencing seizures before MS diagnosis were classified into three categories: (a) 25 (7.3% of patients with MS and seizures) with seizure as the initial presentation of MS; (b) 27 (7.9%) with seizures appearing with other signs and symptoms of MS; and (c) 68 (20%) with seizures occurring years or an unknown period of time before MS onset. Seizure occurring as a symptom of MS relapse was found in 29 patients. The prevalence of seizures among MS patients was higher than that in the general population, indicating a relationship between seizures and MS. Seizures occurred before MS diagnosis in a small percentage of patients.

Topics: Adult; Anticonvulsants; Brain; Electroencephalography; Epilepsy, Tonic-Clonic; Female; Humans; Levetiracetam; Magnetic Resonance Imaging; Multiple Sclerosis; Piracetam; Seizures; Vitamin B 12; Vitamin B 6; Vitamins

We report a 39-year-old man who developed seizures as a predominant symptom of vitamin B12 deficiency. About a month before admission to our hospital, he experienced flickering vision, and had generalized convulsive seizures about ten times a day. On admission, he presented with visual disturbance and paralysis of the left leg. Brain MRI revealed a tumor-like lesion in the medial side of the right frontal lobe. Follow-up MRI about 2 weeks after admission demonstrated multiple lesions in the periaqueduct, the medial side of the bilateral thalami, the bilateral frontal lobes, and the bilateral occipital lobes. After administration of antiepileptic drugs, his condition was well-controlled. Paralysis of his left leg was gradually improved, and abnormal findings on brain MRI disappeared except that in the right frontal lobe cortex, which was considered to be cortical laminar necrosis. 123I-IMP-SPECT showed hyperperfusion in the bilateral occipital lobes. About 3 months after the first admission, he was readmitted because of ataxic gait and numbness in the extremities. Laboratory tests revealed macrocytic anemia and vitamin B12 deficiency. Spinal MRI revealed typical findings of subacute combined degeneration. Brain MRI showed multiple new lesions in the bilateral dorsal sides of the medulla, cerebellar hemispheres, interthalamic adhesion, and left frontal cortex. After the initiation of vitamin B12 supplementary therapy, the symptoms were improved, and the abnormal MRI findings disappeared. Serum anti-gastric-parietal-cell antibody and anti-intrinsic-factor antibody were positive. 123I-IMP-SPECT demonstrated hypoperfusion in the bilateral occipital lobes, possibly reflecting visual disturbance. To the best of our knowledge, this is the first report indicating that vitamin B12 deficiency may insult various brain regions as well as the spinal cord with reversibility. Vitamin B12 deficiency should be also considered in the differential diagnosis of the causes of epilepsy.

Topics: Adult; Brain; Diagnosis, Differential; Encephalomyelitis; Humans; Magnetic Resonance Imaging; Male; Seizures; Treatment Outcome; Vitamin B 12; Vitamin B 12 Deficiency

Epileptic seizures during infancy have a wide variety of clinical presentations and the outcome differs according to the etiology. Among the benign and rare causes of infantile seizures, Vitamin B12 deficiency has been encountered. 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. Involuntary movements and seizures may rarely be the initial symptoms of Vitamin B12 deficiency. Involuntary movements have also been reported to appear after initiation of Vitamin B12 supplementation in isolated cases, whereas, no such information exits for seizures. In this paper, three infants with Vitamin B12 deficiency associated with motor and mental retardation are reported because of long-lasting focal/multifocal epileptic seizures following the initiation of intramuscular Vitamin B12 treatment. Antiepileptics were introduced in addition to Vitamin B12. Seizures disappeared within a few days or weeks; electroencephalographic findings were normalized in a few months. No relapses occurred during the follow-up period.

Topics: Anemia, Megaloblastic; Anticonvulsants; Electroencephalography; Female; Humans; Infant; Male; Seizures; Vitamin B 12; Vitamin B 12 Deficiency; Vitamin B Complex

An elevated serum homocysteine level is a risk factor for the development of cognitive impairment. Reported is a late-onset case of hyperhomocystinemia due to a vitamin B12 metabolic deficit (cobalamin C) with cognitive impairment, primarily in frontal/executive function. After homocysteine-lowering therapy, the patient's functional and neuropsychological status improved in conjunction with a decrease in leukoariosis on his MRI scan. These findings suggest that homocysteine-related cognitive impairment may be partially reversible.

Topics: Adult; Anticoagulants; Betaine; Cognition Disorders; Confusion; Disease Progression; Drug Therapy, Combination; Folic Acid; Frontal Lobe; Homocysteine; Humans; Hyperhomocysteinemia; Leukoaraiosis; Magnetic Resonance Imaging; Male; Methylmalonic Acid; Remission Induction; Seizures; Treatment Outcome; Vitamin B 12; Vitamin B 6

The early onset type of cobalamin (Cbl) C/D deficiency is characterised by feeding difficulties, failure to thrive, hypotonia, seizures, microcephaly and developmental delay. It has an unfavourable outcome, often with early death and significant neurological impairment in survivors. While clinical and biochemical features of Cbl C/D deficiency are well known, only a few isolated case reports are available concerning neurophysiological and neuroimaging findings. We carried out clinical, biochemical, neurophysiological and neuroradiologic investigations in 14 cases with early-onset of the Cbl CID defect. Mental retardation was identified in most of the cases. A variable degree of supratentorial white matter atrophy was detected in 11 cases by MR imaging and tetraventricular hydrocephalus was present in the remaining 3 patients. Waking EEG showed a clear prevalence of epileptiform abnormalities, possibly related to the high incidence of seizures in these cases. Increased latency of evoked responses and/or prolongation of central conduction time were the most significant neurophysiological abnormalities. The selective white matter involvement, shown both by neuroradiologic and neurophysiological studies, seems to be the most consistent finding of Cbl C/D deficiency and may be related to a reduced supply of methyl groups, possibly caused by the dysfunction in the methyl-transfer pathway.

Topics: 5-Methyltetrahydrofolate-Homocysteine S-Methyltransferase; Atrophy; Brain; Brain Diseases, Metabolic, Inborn; Child; Child, Preschool; Cobamides; Cytosol; Electroencephalography; Evoked Potentials; Female; Follow-Up Studies; Homocystinuria; Humans; Infant; Intellectual Disability; Magnetic Resonance Imaging; Male; Methylmalonic Acid; Methylmalonyl-CoA Mutase; Seizures; Vitamin B 12; Vitamin B 12 Deficiency

A six-month-old beagle was presented with a three-month history of failure to gain weight, lethargy, intermittent vomiting and seizures. Hypoglycaemia, portosystemic shunt, lead intoxication, gastrointestinal diseases and hereditary metabolic disorders were considered. Laboratory test results of low serum cobalamin (Cbl) concentrations, anaemia, leucopenia and methylmalonic aciduria while the dog was receiving a balanced commercial canine diet were suggestive of a congenital selective Cbl malabsorption. Treatment with repeated injections of parenteral cyanocobalamin (CN-Cbl) at 50 microg/kg every two weeks corrected the Cbl-deficient state and reversed all the clinical abnormalities. Selective Cbl malabsorption has previously been described in giant schnauzers and border collies and represents a unique readily treatable hereditary metabolic disorder.

Topics: Anemia; Animals; Dogs; Leukopenia; Male; Seizures; Vitamin B 12; Vitamin B 12 Deficiency; Vomiting; Weight Gain

Topics: Animals; Disease Models, Animal; Flurothyl; Folic Acid; Folic Acid Deficiency; Male; Phenobarbital; Rats; Seizures; Vitamin B 12

Topics: Anemia, Hypochromic; Animals; Calcium; Cattle; Cattle Diseases; Copper; Deficiency Diseases; Iron; Lice Infestations; Magnesium; Magnesium Deficiency; Pneumonia; Seizures; Vitamin B 12

Topics: Aged; Blood Proteins; Cerebrospinal Fluid Proteins; Electroencephalography; Folic Acid; Folic Acid Deficiency; Humans; Middle Aged; Phenytoin; Potassium; Seizures; Sodium; Vitamin B 12

Topics: Abortion, Spontaneous; Anemia, Hemolytic, Congenital; Animals; Ascorbic Acid; Ergocalciferols; Female; Humans; Hydrocephalus; Infant, Newborn; Infant, Newborn, Diseases; Jaundice, Neonatal; Maternal-Fetal Exchange; Osteomalacia; Pregnancy; Pregnancy, Prolonged; Pyridoxine; Rats; Scurvy; Seizures; Skull; Vitamin A; Vitamin B 12; Vitamin E; Vitamin K; Vitamins

Topics: Animals; Brain Chemistry; Cysteamine; Dimercaprol; Liver; Rats; Seizures; Sulfhydryl Compounds; Tremor; Vitamin B 12