Pyridoxine-Dependent Seizures Requiring High Doses of Pyridoxine for Control

Abstract

Pyridoxine (or vitamin B₆) dependency is a rare but well-recognized cause of neonatal seizures and, if not treated early, may lead to irreversible mental retardation. The diagnosis depends on the control of clinical and electrical seizure activity by pyridoxine hydrochloride. Previous reports have shown clinical control of seizures in seconds to minutes and EEG control in minutes to days.^1.2Because of the rarity of pyridoxine dependency as a cause of neonatal seizures, the lack of a specific laboratory diagnostic test, and the inexactness of the literature concerning EEG response to therapy, the clinician may overlook this disease. We recently cared for an infant who had focal neonatal seizures that responded to unusually high doses of pyridoxine. <i>Report of a Case</i>.—A 3.0-kg male was lelivered at term by elective cesarean section for double-footling presentation to a 22-year-old gravida 3, para 1, abortus 1 mother. The Apgar score was