Botez M I, Young S N
Department of Medicine, Hôtel Dieu Hospital, Montréal, Québec, Canada.
Brain. 1991 Feb;114 ( Pt 1A):333-48.
A total of 157 epileptic patients were studied with respect to (1) biogenic amine precursors and metabolites in the CSF, (2) levels of folate and thiamine in the blood and CSF, (3) length of treatment with phenytoin (PHT), (4) PHT intoxication, (5) CNS atrophy. Alterations in CSF amine metabolite levels were related primarily to PHT intoxication, and low CSF folate and thiamine levels, but not to length of treatment or CNS atrophy. PHT intoxication increased CSF 5-hydroxyindoleacetic acid (5HIAA). Low folate levels were associated with decreased CSF 5HIAA and homovanillic acid, while low thiamine levels were associated with decreased CSF 5HIAA and 3-methyoxy-4-hydroxyphenylethylene glycol. It remains to be seen to what extent these alterations in biogenic amine metabolism, mediated by low CNS vitamin levels, also lead to deficits in cerebral function.
对157名癫痫患者进行了以下研究：(1) 脑脊液中的生物胺前体和代谢产物；(2) 血液和脑脊液中的叶酸和硫胺素水平；(3) 苯妥英（PHT）治疗时长；(4) PHT中毒；(5) 中枢神经系统萎缩。脑脊液胺代谢产物水平的改变主要与PHT中毒、脑脊液叶酸和硫胺素水平低有关，而与治疗时长或中枢神经系统萎缩无关。PHT中毒会使脑脊液中5-羟吲哚乙酸（5HIAA）增加。叶酸水平低与脑脊液中5HIAA和高香草酸减少有关，而硫胺素水平低与脑脊液中5HIAA和3-甲氧基-4-羟基苯乙二醇减少有关。中枢神经系统维生素水平低介导的这些生物胺代谢改变在多大程度上也会导致脑功能缺陷还有待观察。
