Erdal EREN, Pınar AKYOL, Ayşen TÜREDİ, Şeref OLGAR, Ali AYATA, Bahattin TUNÇ

Vitamin B12 eksikliği epilepsi ilişkisi: İki vaka sunumu

Çocukluk çağında epilepsi prevalansı % 0.5-1 arasında değişmekte ve etyolojisinde vitamin B12 eksikliği nadiren suçlanmaktadır. Kobalamin eksikliği olan hastalarda anormal EEG bulguları saptanmıştır. Deneysel kobalamin eksikliği oluşturulan ratlarda ise nöropatolojik bulgular tespit edilmiş olup, bu durumun BOS IL-6 seviyesinin azalmasına bağlı olduğu düşünülmektedir. Bu yazıda kliniğimizde megaloblastik anemi tanısı alan ve izleminde epilepsi saptanan iki hasta sunulmuştur. Anormal nörolojik bulguları ve konvülziyonları olan süt çocuğu dönemindeki hastalarda diğer nedenler yanında B12 vitamin eksikliğinin de araştırılması uygundur.

Anahtar Kelimeler:

Anemi, megaloblastik, İnterlökin-6, Vitamin B 12 eksikliği, Erkek, Süt çocuğu, Elektroensefalografi, Epilepsi

Vitamin B12 deficiency associated with epilepsy: Two cases

The prevalence of epilepsy is 0.5-1% in childhood. Vitamin B12 deficiency is very rare etiologic cause of epilepsy. Abnormal EEG finding has found in the patient with cobalamin deficient. It has been reported that decreasing of IL-6 levels in cerebrospinal fluid causes neuropathological effects in cobalamin deficient rats. We present two patients with megaloblastic anemia and developing epilepsy during their follow up. Patients who represented with abnormal neurological findings and convulsions, besides the other causes, vitamin B12 deficiency must be investigated.

Keywords:

Anemia, Megaloblastic, Interleukin-6, Vitamin B 12 Deficiency, Male, Infant, Electroencephalography, Epilepsy,

PDF

___

1. Glader B. Anemias of Inadequate Production, Section 2, Chapter 446 In: Behrman RE, Kliegman RM, Jenson HB (eds) Nelson Textbook of Pediatrics (17th edition). Philadelphia: Saunders, 2004: 1612-13.
2. Biancheri R, Cerone R, Rossi A, et al. Early-onset cobalamin C/D deficiency: epilepsy and electroencephalographic features. Epilepsia 2002; 43: 616-22.
3. Convulsions and encephalopathy as initial manifestations of cyanocobalamin deficiency, without hematologic changes. An Med Interna 1990; 7: 34-5.
4. Cobalamin (vitamin B12) positively regulates interleukin-6 levels in rat cerebrospinal fluid. J Neuroimmunol 2002; 127: 37-43.
5. Subacute combined degeneration one century later. The neurotrophic action of cobalamin (vitamin B12) revisited. J Neuropathol Exp Neurol 2001; 60: 109-20.
6. Early-onset combined methylmalonic aciduria and homocystinuria: neuroradiologic findings. Am J Neuroradiol 2001; 22: 554-63.
7. Rasmussen SA, Fernboff PM, Scanlon KS. Vitamin B12 deficiency in children and adolescent. J Pediatr 2001; 138:10-7.
8. Convulsant action of D,L-homocysteic acid and its stereoisomers in immature rats. Epilepsia 1997; 38: 767-76.
9. Optic neuropathy in a patient with vitamin B12 deficiency: a case report. J Med Assoc Thai 1992; 75: 715-8.
10. Peripheral Neuropathy Due to Cobalamin Deficiency. Curr Treat Options Neurol 2002; 4: 197-201.
11. Optic atrophy in association with cobalamin C (cblC) disease. Ophthalmic Genet 2000; 21: 151-4.
12. Chen YT. Defect in Intermediary Carbonhydrate Metabolism Associated with Lactic Acidosis. Chapter 76.4 In: Behrman RE, Kliegman RM, Jenson HB (eds) Nelson Textbook of Pediatrics (17th edition). Philadelphia: Saunders, 2004: 477-480.