ID | 58559 |
FullText URL | |
Author |
Akiyama, Tomoyuki
Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, Okayama University
Kaken ID
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Toda, Soichiro
Kimura, Nobusuke
Department of Pediatrics, Japanese Red Cross Otsu Hospital
Mogami, Yukiko
Department of Pediatric Neurology, Osaka Women’s and Children’s Hospital
Tokorodani, Chiho
Department of Pediatrics, Kochi Health Sciences Center
Ito, Tomoshiro
Department of Pediatrics, Sapporo City General Hospital
Miyahara, Hiroyuki
Department of Pediatrics, Kurashiki Central Hospital
Hyodo, Yuki
Department of Child Neurology, Okayama University Hospital
Kobayashi, Katsuhiro
Department of Child Neurology, Okayama University Hospital
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Abstract | Background
The initial presentation of acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) is indistinguishable from that of complex febrile seizures (FS), which poses a great diagnostic challenge for clinicians. Excitotoxicity is speculated to be the pathogenesis of AESD. Vitamin B6 (VB6) is essential for the biosynthesis of gamma-aminobutyric acid, an inhibitory neurotransmitter. The aim of this study is to investigate our hypothesis that VB6 deficiency in the brain may play a role in AESD.
Methods
We obtained cerebrospinal fluid (CSF) samples from pediatric patients with AESD after early seizures and those with FS. We measured pyridoxal 5′-phosphate (PLP) and pyridoxal (PL) concentrations in the CSF samples using high-performance liquid chromatography with fluorescence detection.
Results
The subjects were 5 patients with AESD and 17 patients with FS. Age did not differ significantly between AESD and FS. In AESD, CSF PLP concentration was marginally lower (p = 0.0999) and the PLP-to-PL ratio was significantly (p = 0.0417) reduced compared to those in FS.
Conclusions
Although it is impossible to conclude that low PLP concentration and PLP-to-PL ratio are causative of AESD, this may be a risk factor for developing AESD. When combined with other markers, this finding may be useful in distinguishing AESD from FS upon initial presentation.
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Keywords | AESD
Biomarker
Febrile seizure
Pyridoxal 5′-phosphate
Pyridoxal kinase
Risk factor
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Note | This is an Accepted Manuscript of an article published by Elsevier.
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Published Date | 2020-05
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Publication Title |
Brain and Development
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Volume | volume42
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Issue | issue5
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Publisher | Elsevier
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Start Page | 402
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End Page | 407
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ISSN | 03877604
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NCID | AA00111153
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Content Type |
Journal Article
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language |
English
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OAI-PMH Set |
岡山大学
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File Version | author
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PubMed ID | |
DOI | |
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Related Url | isVersionOf https://doi.org/10.1016/j.braindev.2020.02.002
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License | https://creativecommons.org/licenses/by-nc-nd/4.0/
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Funder Name |
Ministry of Education, Culture, Sports, Science and Technology
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助成番号 | JP15K09622
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