Huang Hong-Li, Zhou Hao, Wang Nuan, Yu Chun-Yu
Department of Neurology, The First People's Hospital of Xuzhou, Xuzhou, Jiangsu 221000, P.R. China.
Biomed Rep. 2016 Oct;5(4):413-416. doi: 10.3892/br.2016.737. Epub 2016 Aug 8.
Epilepsy is a common neurodegenerative disease with an increasing morbidity. Clinical treatment of epilepsy includes symptomatic treatment, etiological treatment, surgery and prevention. The aim of the present study was to determine the effects of antiepileptic drugs (AEDs) on serum folate and vitamin B12 in various epileptic patients, and to examine the correlation between these effects and secondary cerebrovascular events. A total of 68 epileptic patients, diagnosed between May 2012 and May 2014, were included in the present study. The study included 8 cases of autonomic seizures, 10 cases of absence seizures, 13 cases of complex partial seizures, 28 cases of generalized tonic-clonic seizures, and 9 cases of simple partial seizures. The patients received appropriate AED treatment according to the characteristics of epileptic seizure and the treatment guidance. The differences in the serum levels of folate and vitamin B12 in these patients, and the differences in the secondary cerebrovascular events in these patients after 1 year follow-up were analyzed. The difference in the AEDs used by various epileptic patients was statistically significant (P<0.05). The proportion of AED monotherapy in the autonomic seizure group and petit mal group was highest, and the proportion of two AED in combination with the psychomotor seizure, grand mal and simple partial seizure groups was highest. The serum levels of folate and vitamin B12 in these patients following treatment were significantly lower than those prior to treatment (P<0.05). The differences in the serum levels of folate and vitamin B12 in these groups following treatment were not statistically significant (P>0.05). The difference in the incidence of cerebrovascular events in these groups at follow up was not statistically significant (P>0.05). The multifactorial logistic regression analysis revealed that the serum levels of folate and vitamin B12 were the independent risk factors for epilepsy with secondary cerebrovascular events [folate: odds ratio (OR)=0.536, P=0.039; vitamin: OR=0.382, P=0.041]. In conclusion, various AEDs may decrease the serum levels of folate and vitamin B12 and affect the secondary cerebrovascular events in various epileptic patients. Thus, regular supplementation of folate and vitamin B12 may be an option.
癫痫是一种发病率不断上升的常见神经退行性疾病。癫痫的临床治疗包括对症治疗、病因治疗、手术治疗和预防。本研究的目的是确定抗癫痫药物（AEDs）对各类癫痫患者血清叶酸和维生素B12的影响，并研究这些影响与继发性脑血管事件之间的相关性。本研究共纳入了2012年5月至2014年5月期间诊断的68例癫痫患者。其中包括8例自主神经性发作、10例失神发作、13例复杂部分性发作、28例全身强直阵挛发作和9例简单部分性发作。患者根据癫痫发作特点和治疗指南接受了适当的AED治疗。分析了这些患者血清叶酸和维生素B12水平的差异，以及随访1年后这些患者继发性脑血管事件的差异。各类癫痫患者使用的AEDs差异具有统计学意义（P<0.05）。自主神经性发作组和小发作组AED单药治疗的比例最高，精神运动性发作、大发作和简单部分性发作组联合使用两种AED的比例最高。治疗后这些患者的血清叶酸和维生素B12水平显著低于治疗前（P<0.05）。治疗后这些组血清叶酸和维生素B12水平的差异无统计学意义（P>0.05）。随访时这些组脑血管事件发生率的差异无统计学意义（P>0.05）。多因素logistic回归分析显示，血清叶酸和维生素B12水平是癫痫伴继发性脑血管事件的独立危险因素[叶酸：比值比（OR）=0.536，P=0.039；维生素：OR=0.382，P=0.041]。总之，各种AEDs可能会降低各类癫痫患者的血清叶酸和维生素B12水平，并影响继发性脑血管事件。因此，定期补充叶酸和维生素B12可能是一种选择。
