Epileptic status refractory to conventional treatment caused by vitamin B6 deficiency

Abstract

Epileptic seizures due to pyridoxine deficiency, although rare, are known to occur. They are characterized by untreatable convulsions during childhood. We present the case of an epileptic status resistant to conventional treatment in a 29-year-old woman, with no previous history of epileptic seizures, in the 29th week of pregnancy, who responded to the intravenous administration of pyridoxine.

Magnesium sulfate for non-eclamptic status epilepticus

“…Of the 22 articles included in the review , 19 were original studies [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35] and 3 were companion publications [36][37][38] with duplicate patient data. Madisi et al [36] and Madisi et al [37] were meeting proceedings describing the same patient that was eventually described and updated meeting proceeding Berkeley et al [18].…”

“…However, Sahin et al [38] provided some longer term follow up data on one patient in Sahin et al [28], which was included in the outcome data section. All 19 original studies were retrospective studies [17][18][19][20][21][22][23][24][25][26][27][28][29][30][31][32][33][34][35], with 3 retrospective case series [28,31,35] and 16 retrospective case reports [17][18][19][20][21][22][23][24][25][26][27]29,30,[32][33][34]. All were single center reports.…”

“…All were single center reports. Eleven articles described the use of MgSO 4 in adults [18,21,[23][24][25][26]29,30,32,34,35]. Eight studies described pediatric patients [17,19,20,22,27,28,33,35].…”

“…Seizures were classified as GSE in 1 patient [27], GRSE in 13 patients [17,18,[20][21][22][23]25,26,28,32,34,35], FRSE in 2 patients [19,29], MFRSE in 2 patients [28,33], NCRSE in 1 patient [30], and non defined SE/RSE in 9 patients [24,31].…”

“…The etiology of SE/RSE varied significantly and were as follows: fever induced refractory epilepsy syndrome (FIRES)/New onset resistant status epilepticus (NORSE) in 3 patients [18,23,33], autoimmune encephalitis in 2 patients [19,24], known pre-existing epilepsy in 3 patients [20,22,32], encephalitis in 3 patients [22,28], acute intermittent porphyria (AIP) in 1 patient [27], POLG1 mutation with associated epilepsy in 3 patients [29,35], paraneoplastic related in 1 patient [30], vitamin B6 deficiency in 1 patient [34], and unknown in 11 patients [17,25,26,31].…”