Document Detail


Pyridoxine-dependent seizures: a clinical and biochemical conundrum.
MedLine Citation:
PMID:  12686105     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Pyridoxine-dependent seizures have been recognised for 40 years, but the clinical and biochemical features are still not understood. It is a rare recessively inherited condition where classically a baby starts convulsing in utero and continues to do so after birth, until given pyridoxine. Many of these early onset cases also have an acute encephalopathy and other clinical features. Late onset cases are now recognised with a less severe form of the condition. Seizures can break through with intercurrent illness but otherwise remain controlled on pharmacologic doses of pyridoxine. The long-term outcome is affected by several factors including whether onset is early or late and how soon pyridoxine is given. Biochemical studies have been sparse, on very small numbers. There does not appear to be any defect in the uptake or metabolism of pyridoxine or pyridoxal phosphate (PLP). For a long time glutamic acid decarboxylase (GAD), a pyridoxal-dependent enzyme, has been suspected to be the abnormal gene product, but glutamate and gamma-aminobutyric acid (GABA) studies on the cerebrospinal fluid (CSF) have been contradictory and recent genetic studies have not found any linkage to the two brain isoforms. A recent report describes raised pipecolic acid levels in patients but how this ties in is unexplained.
Authors:
Peter Baxter
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Publication Detail:
Type:  Journal Article; Review    
Journal Detail:
Title:  Biochimica et biophysica acta     Volume:  1647     ISSN:  0006-3002     ISO Abbreviation:  Biochim. Biophys. Acta     Publication Date:  2003 Apr 
Date Detail:
Created Date:  2003-04-10     Completed Date:  2003-06-05     Revised Date:  2005-11-16    
Medline Journal Info:
Nlm Unique ID:  0217513     Medline TA:  Biochim Biophys Acta     Country:  Netherlands    
Other Details:
Languages:  eng     Pagination:  36-41     Citation Subset:  IM    
Affiliation:
Ryegate Centre Paediatric Neurology, Sheffield Childrens Hospital, Tapton Crescent Road, Sheffield S10 5DD, UK. p.s.baxter@shefffield.ac.uk
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MeSH Terms
Descriptor/Qualifier:
Humans
Overdose
Pyridoxal Phosphate / metabolism
Pyridoxine / deficiency,  metabolism,  therapeutic use*
Seizures / drug therapy*,  metabolism
gamma-Aminobutyric Acid / biosynthesis
Chemical
Reg. No./Substance:
54-47-7/Pyridoxal Phosphate; 56-12-2/gamma-Aminobutyric Acid; 65-23-6/Pyridoxine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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