| The EEG response to pyridoxine-IV neither identifies nor excludes pyridoxine-dependent epilepsy. | |
| | |
MedLine Citation:
|
PMID: 20887371 Owner: NLM Status: In-Process |
Abstract/OtherAbstract:
|
PURPOSE: Pyridoxine-dependent epilepsy (PDE) is characterized by therapy-resistant seizures (TRS) responding to intravenous (IV) pyridoxine. PDE can be identified by increased urinary alpha-aminoadipic semialdehyde (α-AASA) concentrations and mutations in the ALDH7A1 (antiquitin) gene. Prompt recognition of PDE is important for treatment and prognosis of seizures. We aimed to determine whether immediate electroencephalography (EEG) alterations by pyridoxine-IV can identify PDE in neonates with TRS. METHODS: In 10 neonates with TRS, we compared online EEG alterations by pyridoxine-IV between PDE (n = 6) and non-PDE (n = 4). EEG segments were visually and digitally analyzed for average background amplitude and total power and relative power (background activity magnitude per frequency band and contribution of the frequency band to the spectrum). RESULTS: In 3 of 10 neonates with TRS (2 of 6 PDE and 1 of 4 non-PDE neonates), pyridoxine-IV caused flattening of the EEG amplitude and attenuation of epileptic activity. Quantitative EEG alterations by pyridoxine-IV consisted of (1) decreased central amplitude, p < 0.05 [PDE: median -30% (range -78% to -3%); non-PDE: -20% (range -45% to -12%)]; (2) unaltered relative power; (3) decreased total power, p < 0.05 [PDE: -31% (-77% to -1%); -27% (-73% to -13%); -35% (-56% to -8%) and non-PDE: -16% (-43% to -5%); -28% (-29% to -17%); -26% (-54% to -8%), in delta-, theta- and beta-frequency bands, respectively]; and (4) similar EEG responses in PDE and non-PDE. DISCUSSION: In neonates with TRS, pyridoxine-IV induces nonspecific EEG responses that neither identify nor exclude PDE. These data suggest that neonates with TRS should receive pyridoxine until PDE is fully excluded by metabolic and/or DNA analysis. |
| | |
Authors:
|
Levinus A Bok; Natasha M Maurits; Michèl A Willemsen; Cornelis Jakobs; Laura K Teune; Bwee Tien Poll-The; Irenaeus F de Coo; Mona C Toet; Eveline E Hagebeuk; Oebele F Brouwer; Johannes H van der Hoeven; Deborah A Sival |
Publication Detail:
|
Type: Journal Article Date: 2010-09-30 |
Journal Detail:
|
Title: Epilepsia Volume: 51 ISSN: 1528-1167 ISO Abbreviation: Epilepsia Publication Date: 2010 Dec |
Date Detail:
|
Created Date: 2010-12-02 Completed Date: - Revised Date: - |
Medline Journal Info:
|
Nlm Unique ID: 2983306R Medline TA: Epilepsia Country: United States |
Other Details:
|
Languages: eng Pagination: 2406-11 Citation Subset: IM |
Copyright Information:
|
Wiley Periodicals, Inc. © 2010 International League Against Epilepsy. |
Affiliation:
|
Department of Pediatrics, Máxima Medical Center, Veldhoven, The Netherlands. |
Export Citation:
|
APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
|
|
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
Previous Document: Neurocognitive effects of brivaracetam, levetiracetam, and lorazepam.
Next Document: Lymphomatoid hypersensitivity reaction to levofloxacin during autologous stem cell transplantation: ...