B6 defiecient seizures have the same characteristics and EEG abnormalities as other seizure disorders and if not recognized and treated can result in mental retardation. The diagnosis of B6 dependency should be suspected in every infant with convulsions during the first 18 months of life.
Certain clinical features may include: Seizures of unknown orgin in a previously normal child. A history of severe convulsive disorders. The occurance of long lasting focal or unilateral seizures accompanied by partial loss of consciousness. Restlessness, crying or agitation preceding the seizure.
It is suggested by some doctors that when there is no clear cut reason that a trial of B6 be done. A 100-200 mg. intravenous dose or 20 mg. every 5 minutes for a total of 200 mg. be given. If the seizures stop it is more likely than not that the child has B6 responsive seizures. It has been shown that the chance to identify B6 seizures is loss if they are given in conjunction with anticonvulsant medication.
Once identifyed as B6 related constant doses of within the range of 25-50 mg. per day should be given. The mechanisim as to how this work is still unclear and being studied. One therory suggest that people with this type of disorder require more B6 to activate the enzyme GABA.
One study showed that infants with uncontrolled infantile spasms found improvement anywhere from 2-14 days of starting does of B6. Almost all showed improved results in thier EEG's.
This is not to say that B6 administered at such high doses go without side effects. A few of these include: headaches, nausea and vomiting. Administration should be strictly monitored as high doses do interfere with certain anticonvulsants.
Currently B6 is being studied in older childeren and adults to see if it can be an asset in improving their quality of life. At this time, however, nothing has been made available.
Next time we will cover the role that Folic Acid plays in seizure control.
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