Plasma Level of Homocysteine, Folic Acid and Vitamin B12 Before and After Folic Acid Supplementation in Epileptic Children

Abstract

T he aim of this study is to uncover the relationship between the levels of homocysteine and the cofactors involved in its metabolism as folic acid and vitamin B12 with anti-epileptic drugs in epileptic patients and their role in epilepsy control before and after supplementation of 5mg folic acid daily in the morning for three months. This study was conducted in Ain Shams University hospitals, Pediatric Neurology Clinic, on 8o epileptic children with idiopathic epilepsy that were divided into 4 groups:  Group 1: 20 patients receiving valproic acid.  Group 2: 20 patients receiving carbamazepin.  Group 3: 20 patients receiving single new antiepileptic drug (levetiracetam).  Group 4: 20 patients receiving polytherapy.  Controls: 20 non-epileptic healthy children of the same mean age and sex of the patients. • All children were subjected to full history taking, complete clinical examination and investigations as CBC, determination of serum levels of folic acid, vitamin B12 and Hcy, EEG and neuroimaging. There were no significant differences in age, gender, mean age of onset, duration of seizures and weight between the four groups of patients administering antiepileptic drugs compared to each other and compared to controls. All patients were supplemented with 5mg folate each morning for 90 days. Serum level of homocystine, folic acid and antiepileptic drugs were measured one day before treatment and after 90 days post treatment. The results of this study revealed: • Homocysteine was significantly increased in serum of epileptic patients receiving valproic acid, Polytherapy and carbamazepin compared to controls. In Levetiracetam receiving patients, homocysteine was non-significantly increased compared to controls. • Folic acid was significantly decreased in epileptic patients receiving Valporate, polytherapy and Carbazepine compared to controls. Except for Levetiracetam, where folic acid showed no significant differences in serum of patients compared to controls.