PMID- 17066742
OWN - NLM
STAT- MEDLINE
DCOM- 20061219
LR  - 20061027
IS  - 1214-6994 (Print)
IS  - 1214-6994 (Linking)
VI  - 107
IP  - 2
DP  - 2006
TI  - Moderate hyperhomocysteinemia in patients treated for epilepsy.
PG  - 227-41
AB  - Homocystein (Hcy) is regarded as a neuroexcitatory substance, which is therefore 
      used as an epileptogenic agent in experimental epileptology. Experiments "in 
      vivo" as well as "in vitro" revealed its relation to NMDA glutamate receptors, 
      and its potential neurotoxicity. From the clinical aspect, hyperhomocysteinemia 
      (HHcy), mostly as a marker of the risk factor in the vascular damage, was often 
      studied in patients treated with antiepileptic drugs (AE). However, the 
      neuroexcitatory influence of mild HHcy (up to 30 micromol/l) was rarely 
      discussed. Out of a group of 123 adult patients on long-term conventional AE we 
      analyzed 8 patients (7 men and one woman) with moderate to severe HHcy 
      (30.7-109.0 micromol/l) retrospectively and 2-5 years after HHcy normalization. 
      All of them suffered from partial and/or secondary generalized seizures 
      accompanied by neuropsychological impairment depending on the aetiology of the 
      disease. The patients were characterized by a concurrence of several factors: (1) 
      All of them received conventional AEs inducing the cytochrome P 450 at the time 
      HHcy was diagnosed. (2) Molecular-genetic tests showed enzymopathic impairment 
      (methylentetrahydrofolate reductase-MTHFR mutation of the gene C677 T) also in 
      all eight, homozygous in 7 cases and heterozygous in 1 case. (3) All patients 
      were found to have a vitamin deficit or marginal values of at least one of the 
      vitamins under study, especially folate and/or vitamin B6 and 812. With reference 
      to clinical and EEG features, the potential neuroexcitatory influence of Hcy is 
      discussed taking into account its effect on pathogenetic factors.
FAU - Kolinova, M
AU  - Kolinova M
AD  - Department of Neurology of the Faculty Policlinic of the First Faculty of 
      Medicine, Charles University in Prague, Czech Republic. kolinova.marie@vfn.cz
FAU - Dvorakova, J
AU  - Dvorakova J
FAU - Hladikova, E
AU  - Hladikova E
FAU - Preiss, J
AU  - Preiss J
FAU - Hyanek, J
AU  - Hyanek J
LA  - eng
PT  - Journal Article
PL  - Czech Republic
TA  - Prague Med Rep
JT  - Prague medical report
JID - 101227436
RN  - 0 (Anticonvulsants)
RN  - 0 (Vitamins)
SB  - IM
MH  - Adult
MH  - Aged
MH  - Anticonvulsants/*adverse effects
MH  - Electroencephalography
MH  - Epilepsy/*drug therapy/physiopathology
MH  - Female
MH  - Humans
MH  - Hyperhomocysteinemia/*chemically induced/drug therapy
MH  - Male
MH  - Middle Aged
MH  - Vitamins/therapeutic use
EDAT- 2006/10/28 09:00
MHDA- 2006/12/21 09:00
CRDT- 2006/10/28 09:00
PHST- 2006/10/28 09:00 [pubmed]
PHST- 2006/12/21 09:00 [medline]
PHST- 2006/10/28 09:00 [entrez]
PST - ppublish
SO  - Prague Med Rep. 2006;107(2):227-41.