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Article
Vitamin B6 Deficiency A Potential Cause of Refractory Seizures in Adults
Journal of Parenteral and Enteral Nutrition
  • Anthony T. Gerlach
  • Sheela Thomas
  • Stanislaw P. Stawicki
  • Melissa L. Whitmill, Wright State University
  • Steven M. Steinberg
  • Charles H. Cook
Document Type
Article
Publication Date
3-1-2011
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Abstract
Objective: In children, vitamin B6 (pyridoxine) deficiency has been described as a cause of seizures that are refractory to conventional antiepileptic medications. We describe the clinical presentation of 3 adults with refractory seizures (later diagnosed with vitamin B6 deficiency) that resolved after pyridoxine treatment. Design: Case series. Setting: Tertiary care surgical intensive care unit. Patients: In the first case, a 54-year-old male with history of alcoholic cirrhosis developed new-onset seizures refractory to phenytoin and levetiracetam 8 days after liver transplantation. In the second case, a 59-year-old male with hepatitis C infection developed intracranial hemorrhage and new-onset seizures refractory to phenytoin, levetiracetam, and pentobarbital. The third patient is a 78-year-old male with a history of alcohol dependence who was admitted for an intraventricular bleed and developed new onset of refractory seizures. Interventions: Intravenous pyridoxine followed by oral pyridoxine. Measurement and Main Results: In all 3 cases, seizures persisted despite escalation of conventional antiepileptic medications but resolved within 2 days of pyridoxine supplementation. In each case, low serum pyridoxal 5′-phosphate concentrations normalized with pyridoxine administration. Conclusions: Although refractory seizures caused by vitamin B6 deficiency are rare in adults, it should be considered in critically ill adult patients with refractory seizures.
DOI
10.1177/0148607110384118
Citation Information
Anthony T. Gerlach, Sheela Thomas, Stanislaw P. Stawicki, Melissa L. Whitmill, et al.. "Vitamin B6 Deficiency A Potential Cause of Refractory Seizures in Adults" Journal of Parenteral and Enteral Nutrition Vol. 35 Iss. 2 (2011) p. 272 - 275 ISSN: 0148-6071
Available at: http://works.bepress.com/melissa_whitmill/6/