Nathan Cody L, Ghandour Dina, May Jasmine, Bega Danny, Schuele Stephan
Department of Neurology, Northwestern Memorial Hospital, Chicago, IL, USA.
Neurohospitalist. 2025 Jul 9:19418744251360306. doi: 10.1177/19418744251360306.
The association between Parkinson's disease and epilepsy remains unclear. A higher proportion of patients with Parkinson's disease who have experienced seizures had at least one episode of status epilepticus compared to healthy controls. It is crucial to distinguish whether seizures are provoked or unprovoked as this changes the long-term treatment plan and prognosis.
We report a case of new onset seizures refractory to multiple anti-seizure medications in a patient with Parkinson's disease in the context of vitamin B6 deficiency. The seizures started after a recent increase in carbidopa/levodopa dose. Seizures resolved with pyridoxine supplementation. The patient was able to successfully wean off all anti-seizure medications without any further seizures and had incomplete normalization of EEG.
Clinicians should consider vitamin B6 deficiency as an etiology for new-onset refractory seizures in patients with Parkinson's disease on carbidopa/levodopa. Repletion of vitamin B6 can be curative, and patients may ultimately not require long term anti-seizure medications.
帕金森病与癫痫之间的关联仍不明确。与健康对照相比，经历过癫痫发作的帕金森病患者中，有更高比例的人至少有一次癫痫持续状态发作。区分癫痫发作是诱发性还是原发性至关重要，因为这会改变长期治疗方案和预后。
我们报告一例帕金森病患者在维生素B6缺乏的情况下出现对多种抗癫痫药物难治的新发癫痫发作。癫痫发作在近期卡比多巴/左旋多巴剂量增加后开始。补充吡哆醇后癫痫发作得到缓解。患者能够成功停用所有抗癫痫药物且未再发作，脑电图未完全恢复正常。
临床医生应将维生素B6缺乏视为服用卡比多巴/左旋多巴的帕金森病患者新发难治性癫痫发作的一个病因。补充维生素B6可能治愈疾病，患者最终可能无需长期服用抗癫痫药物。
