Abstracts

Elevated plasma homocysteine level (hyperhomocysteinemia) is associated with various vascular diseases, abortion, and cancer. In epilepsy, prolonged antiepileptic drugs induce hyperhomocysteinemia, especially in the methylenetetrahydrofolate reductase (MTHFR) TT type, which induce cerebrovascular disease and congenital fetal abnormalities such as neural tube defects. Because folic acid decreases homocysteine level, folic acid is useful treatment in patients with hyperhomocysteinemia.We studied to assess factors that have affects on the decrease of homocysteine levels in epilepsy patients, especially according to single nucleotide polymorphisms., We prospectively included 75 epilepsy patients admitted at Pundang CHA Hospital between 2002 and 2005. All patients treated with antiepileptic drugs during one year and examined homocysteine levels at two times: initial and last time (one year later). When hyperhomocysteinema (homocysitne [gt] 12[micro]mol/L) was found at initial time, patients were supplemented with daily 400[mu]g folic acid for one year. All patients were divided into two groups; increase group (IG) and decrease group (DG) according to the change of homocysteine levels between initial and last time. Also, all patients examined various polymorphisms, such as MTHFR C677T, MTHFR A1298C, methionine synthase A2756G, and thymidylate synthase gene polymorphisms., Among 75 patients, IG was 31 patients and DG was 44 patients. Decrease of homocysteine levels during one year was observed in young age, initial high level of homocysteine, use of folic acid, presence of family history, and semiology of complex partial seizure. There were no significant differences of homocysteine levels according to polymorphisms., Our results suggest that folic acid can cheaply decrease homocysteine levels in epilepsy patients with hyperhomocysteinemia. We recommend administration of folic acid in old epilepsy patients with generalized and symptomatic seizures since homocyteine level did not increase in the young age patients with complex partial seizure and family history.,