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Pyridoxine-dependent seizures caused by alpha amino adipic semialdehyde dehydrogenase deficiency: the first polish case with confirmed biochemical and molecular pathology.

Abstract
Pyridoxine-dependent seizures are a rare condition recognized when numerous seizures respond to pyridoxine treatment and recur on pyridoxine withdrawal. For decades the diagnosis was confirmed only with pyridoxine treatment withdrawal trial. Recently described biochemical and molecular pathology improved the diagnostic process for those cases in which seizures are caused by alpha amino adipic semialdehyde dehydrogenase deficiency. This article presents a girl with recurrent status epilepticus episodes resistant to phenobarbital and phenytoin and partly responding to midazolam. Eventually the seizures were completely controlled with pyridoxine; however, due to the severe condition of this child when seizing, no trial of withdrawal has been performed. The diagnosis of pyridoxine-dependent seizures was confirmed with biochemical and molecular testing revealing elevated alpha-AASA excretion and the presence of 2 different mutations in the antiquitin ( ALDH7A1) gene. Due to the availability of reliable laboratory testing, confirmation of the diagnosis was made without the life-threatening trial of pyridoxine withdrawal.
AuthorsMagdalena Kaczorowska, Tomasz Kmiec, Cornelis Jakobs, Marek Kacinski, Slawomir Kroczka, Gajja S Salomons, Eduard A Struys, Sergiusz Jozwiak
JournalJournal of child neurology (J Child Neurol) Vol. 23 Issue 12 Pg. 1455-9 (Dec 2008) ISSN: 1708-8283 [Electronic] United States
PMID18854520 (Publication Type: Case Reports, Journal Article)
Chemical References
  • Vitamin B Complex
  • 2-Aminoadipic Acid
  • allysine
  • ALDH7A1 protein, human
  • Aldehyde Dehydrogenase
  • Pyridoxine
Topics
  • 2-Aminoadipic Acid (analogs & derivatives, deficiency)
  • Aldehyde Dehydrogenase (genetics)
  • Female
  • Humans
  • Poland
  • Pyridoxine (therapeutic use)
  • Seizures (drug therapy, etiology, genetics)
  • Vitamin B Complex (therapeutic use)

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