Efficacy of Pyridoxine in Early-Onset Idiopathic Intractable Seizures in Children.
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Date
2010-11
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Abstract
Objective To identify pyridoxine responsive seizures
among children with early onset intractable seizures, and
to identify pyridoxine-dependency as a subset in this group.
Methods Patients with neonatal onset idiopathic, intractable
seizures were identified over a 6-month period and subjected
to a ‘pyridoxine trial’, at the Pediatric Neurology Clinic of a
tertiary-care teaching hospital in New Delhi, India. This
consisted of an intravenous infusion of 100 mg of pyridoxine
over 10-min with a simultaneous EEG monitoring. This
procedure was carried out in the EEG laboratory with all
appropriate precautions (including availability of resuscitation Results 621 children with active epilepsy were seen at the
PNC, of which 48 had early-onset, medical intractable
epilepsy, and 21 children (13 males and 8 females), aged
between 11 month and 38 month were enrolled. The
median age at onset of seizure was 5.1 months. The major
seizure type was focal in 3 and generalized in 18 (including
infantile spasm in 11). No patient had normalization of
EEG during the ‘trial’. Two patients (9.5%) had a response
during the 2 weeks of oral treatment and oral therapy was
continued. No toxicity or side-effects of pyridoxine were
observed in these two patients over a follow-up of more
than 18 months.
Conclusions Pyridoxine responsive seizures contribute a
significant proportion to early-onset idiopathic intractable
epilepsy in childhood. Routine use of pyridoxine in the
management of early onset resistant seizures would go a
long way in identifying these patients early.
Description
Keywords
Antiepileptic drugs, India, Infantile spasms, Pyridoxine, Resistant epilepsy
Citation
Mishra Devendra, Kalra Veena, Seth Rachna, Gulati Sheffali, Saha Narayan. Efficacy of Pyridoxine in Early-Onset Idiopathic Intractable Seizures in Children. Indian Journal of Pediatrics. 2010 Nov ; 77 (11): 1252-1256.