摘要
Aim: To study the difference between pyridoxine (PN) and its active form, pyri doxal phosphate, (PLP) in control of idiopathic intractable epilepsy in children . Methods: Among 574 children with active epilepsy, 94 (aged 8 months to 15 year s) were diagnosed with idiopathic intractable epilepsy for more than six months. All received intravenous PLP 10 mg/kg, then 10 mg/kg/day in four divided doses. If seizures recurred within 24 hours, another dose of 40 mg/kg was given, follo wed by 50 mg/kg/day in four divided doses. For those patients whose seizures wer e totally controlled, PLP was replaced by the same dose of oral PN. If the seizu re recurred, intravenous PLP was infused followed by oral PLP 50 mg/kg/day. Resu lts: Fifty seven patients had generalised seizures (of whom 13 had infantile spa sms) and 37 had focal seizure. Eleven had dramatic and sustained responses to PL P; of these, five also responded to PN. Within six months of treatment with PLP or PN, five of the 11 patients were seizure free and had their previous antiepileptic medicine tapered off gradually. Two were controlled wit h pyridoxine and the other three needed PLP to maintain seizure freedom. The rem aining six responders needed PLP exclusively for seizure control. Six of the 11 responders to PLP had infantile spasms (46%); four of them needed PLP exclusive ly. The other five responders were in the remaining 81 patients with other seizu re type. Conclusions: PLP could replace PN in the treatment of intractable child hood epilepsy, particularly in the treatment of infantile spasms.
Aim: To study the difference between pyridoxine (PN) and its active form, pyri doxal phosphate, (PLP) in control of idiopathic intractable epilepsy in children . Methods: Among 574 children with active epilepsy, 94 (aged 8 months to 15 year s) were diagnosed with idiopathic intractable epilepsy for more than six months. All received intravenous PLP 10 mg/kg, then 10 mg/kg/day in four divided doses. If seizures recurred within 24 hours, another dose of 40 mg/kg was given, follo wed by 50 mg/kg/day in four divided doses. For those patients whose seizures wer e totally controlled, PLP was replaced by the same dose of oral PN. If the seizu re recurred, intravenous PLP was infused followed by oral PLP 50 mg/kg/day. Resu lts: Fifty seven patients had generalised seizures (of whom 13 had infantile spa sms) and 37 had focal seizure. Eleven had dramatic and sustained responses to PL P; of these, five also responded to PN. Within six months of treatment with PLP or PN, five of the 11 patients were seizure free and had their previous antiepileptic medicine tapered off gradually. Two were controlled wit h pyridoxine and the other three needed PLP to maintain seizure freedom. The rem aining six responders needed PLP exclusively for seizure control. Six of the 11 responders to PLP had infantile spasms (46%); four of them needed PLP exclusive ly. The other five responders were in the remaining 81 patients with other seizu re type. Conclusions: PLP could replace PN in the treatment of intractable child hood epilepsy, particularly in the treatment of infantile spasms.
