All About Vitamins: Vitamin B6 and Treatment of Pyridoxine-Dependent Epilepsy

By Kyle J. Norton.

Epilepsy is a neuro disease characterized by abnormal electrical activity in the brain with condition of sudden recurrent episodes of sensory disturbance.

Vitamin B6, also known as pyridoxine, is a water soluble vitamin found abundantly in green peas, yams, broccoli, asparagus and turnip greens,Peanuts, sunflower seeds, cashews and hazelnuts, meat, fish etc., with functions in stimulation of carbohydrate metabolism, brain health, and liver detoxification, etc.

The effect of vitamin B6 in treatment of pyridoxine-dependent epilepsy was under microscopic investigations extensively through many aspects, particularly in vitamin B6 application.

In inborn errors of autosomal recessive inheritance that lead to vitamin B6-dependent seizures, after taking account of other con founders, researchers suggested that a vitamin B6 withdrawal for diagnose should also be considered as an therapy for resistant neonatal seizures as early consideration of a vitamin B6 trial over 3 consecutive days is crucial in order to prevent irreversible brain damage, instead of only for patients with a clear vitamin B6 response.

Neonatal seizures, a medical condition of occurrence of seizures due to neurologic dysfunction in the neonatal period.

Pyridoxine, an the active form of vitamin B6 would be effective commonly in treatment of vitamin B6-dependent seizures, but pyridoxine showed no signs of potency in patients with neonatal seizures due to PNPO deficiency.

Pyridoxal 5'-phosphate-dependent epilepsy(PNPO) is a condition with failure response to vitamin B6 treatment in seizures patients.

The use of PLP in patients with resistant neonatal seizures should be taken with care with resuscitation equipment at hand during a first pyridoxine/PLP administration, as severe apnea has been occurred in patients, researcher continued.

Unfortunately, due to PLP is unlicensed within Europe and North America, pyridoxine is widely used as the first line drug, therefore for patient do not response to the treatment of PLP, some researchers suggested that PLP injection may be necessary and should be followed by a trial, especially in neonates.

Furthermore, caregivers, including parents with children with epilepsy should be inform about the lifelong dependency and recurrence risks in forthcoming pregnancies.

Further analysis of  the resistant conventional antiepileptic medications of early-onset epilepsy in children with neonates caused by hypophosphatasia and congenital rickets and in compared to patients of hyperprolinemia type 2, antiquitin deficiency, and pyridoxine phosphate oxidase deficiency of epilepsy, also indicated that although many patients with epilepsy are response to treatment of vitamin B6 injection but PLP treatment was more effective than pyridoxine, through some unknown mechanisms.

Dr. Wang HS, the lead author said, "Since PLP is as inexpensive as pyridoxine, we suggest replacing PLP for pyridoxine when treating children with epilepsy".

Additionally, Pyridoxine-dependent epilepsy (PDE) may also be caused by genetic mutation of certain genes, such as c.1597_1597delG mutations in ALDH7A1 gene.

Observation of patients data in 3 groups with complete seizure control with pyridoxine and normal development (group 1), complete seizure control with pyridoxine and development delay (group 2), and patients with persistent seizures despite pyridoxine treatment and with development delay (group 3) researchers at the Çukurova University Faculty of Medicine found that early diagnosis and treatment of these patients is vital. Patients with persistent seizure despite pyridoxine treatment and with development delay should be diagnosed in condition of any neonate with signs of encephalopathy and refractory seizures.

Taken together, if patients with epilepsy do not response to treatment of application of vitamin B6, PLP injection may be considered but substantial care must be taken  to reduce risk of complications of severe apnea.
 

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Sources
(1) Pyridoxine and pyridoxalphosphate-dependent epilepsies by Plecko B1.(PubMed)
(2) Vitamin B6 related epilepsy during childhood by Wang HS1, Kuo MF.(PubMed)
(3) Pyridoxine-dependent epilepsy in two Turkish patients in Turkey and review of the literature by Gül-Mert G1, İncecik F, Hergüner MÖ, Ceylaner S, Altunbaşak Ş.(PubMed)

Biography
Kyle J. Norton(Scholar, Master of Nutrients), all right reserved.
Health article writer and researcher; Over 10.000 articles and research papers have been written and published on line, including world wide health, ezine articles, article base, healthblogs, selfgrowth, best before it's news, the karate GB daily, etc.,.
Named TOP 50 MEDICAL ESSAYS FOR ARTISTS & AUTHORS TO READ by Disilgold.com Named 50 of the best health Tweeters Canada - Huffington Post
Nominated for shorty award over last 4 years
Some articles have been used as references in medical research, such as international journal Pharma and Bio science, ISSN 0975-6299.