Kirik Serkan, Çatak Zekiye
Pediatric Neurology, Fırat University School of Medicine, Elazig, TUR.
Department of Medical Biochemistry and Clinical Biochemistry, Elazig Fethi Sekin City Hospital, Elazig, TUR.
Cureus. 2021 Mar 6;13(3):e13745. doi: 10.7759/cureus.13745.
Vitamin B12 deficiency can lead to many different types of neurological symptoms and seizure can be seen as the first symptom. In the present study, we aimed to evaluate patients with seizures who were found to have vitamin B12 deficiency and whose seizures resolved with vitamin B12 treatment.
A total of 26 infants were included in this retrospective study. The patients were evaluated in terms of clinical findings, laboratory tests including homocysteine, electrophysiological studies, neuroimaging studies, and other neurological examination findings.
Of 26 patients, 14 (53.8%) were male. The mean age of the patients was 8±4.8 months. Sixteen patients had generalized tonic-clonic seizures, and two patients had epileptic spasm (West syndrome)-type seizures. Six patients had abnormal discharge on electroencephalography. Twelve patients had abnormal findings in brain magnetic resonance imaging studies. Homocysteine level was high in all patients at admission.
The presence of seizures, including infantile spasm, is a very important and treatable manifestation of vitamin B12 deficiency. Considering the irreversible sequelae of increased homocysteine, vitamin B12 supplementation administered for an appropriate period and at an appropriate dose both prevents the use of unnecessary antiepileptic drugs and eliminates the need for unnecessary tests and examinations.
维生素B12缺乏可导致多种不同类型的神经症状，癫痫发作可为首发症状。在本研究中，我们旨在评估那些被发现维生素B12缺乏且癫痫发作经维生素B12治疗后缓解的患者。
本回顾性研究共纳入26例婴儿。对患者进行了临床检查、包括同型半胱氨酸在内的实验室检查、电生理研究、神经影像学研究以及其他神经学检查结果的评估。
26例患者中，14例（53.8%）为男性。患者的平均年龄为8±4.8个月。16例患者出现全身强直阵挛发作，2例患者出现癫痫痉挛（韦斯特综合征）型发作。6例患者脑电图有异常放电。12例患者脑磁共振成像研究有异常发现。所有患者入院时同型半胱氨酸水平均较高。
包括婴儿痉挛在内的癫痫发作是维生素B12缺乏的一种非常重要且可治疗的表现。考虑到同型半胱氨酸升高的不可逆后遗症，在适当的时期给予适当剂量的维生素B12补充剂，既能避免使用不必要的抗癫痫药物，又能消除不必要检查的需求。
