Abstracts

Rationale: Previously many studies showed the deficiency of thiamine (carnitine, cobalamin, folic acid) results in epileptic seizure. The antiepileptic drugs, such as valproic acid, induce carnitine deficiency. Like chicken and egg problem, epilepsy is induced by these deficiency, and epilepsy itself may make these deficiency. In epilepsy patients, supplementation of thiamine, carnitine, folic acid if these are deficient may play an important role for therapeutic use. Methods: We retrospectively examined consecutive 33 newly diagnosed epilepsy patients. Their first visit to our hospital was on Thursday from October 2018 to May 2019. One epilepsy specialist evaluated all patients. The 2 patients who previously used valproic acid were excluded. We examined their serum thiamine, total carnitine, free carnitine, cobalamin, folic acid levels. The 7 patients who had no sufficient vitamin data were also excluded. Based on reference value we defined a low thiamine as a serum thiamine level < 24 ng/mL. A low total carnitine < 45 μmol/L, a low free carnitine < 36 μmol/L, a low cobalamin < 197 pg/mL, a low folic acid < 3.8 ng/mL. The 33 patients had no past medical history of abdominal surgery. Results: 24 patients (male : female = 1:1) were enrolled. The age was 37±24 (mean±SD)(range 14 - 83). 29% of the patients had a low thiamine. 41% - a low total carnitine, 35% - a low free carnitine, 4% - a low cobalamin, 43% - a low folic acid, respectively. These mean value are thiamine - 28 ng/mL, total carnitine - 45 μmol/L, free carnitine - 37 μmol/L, cobalamin - 488 pg/mL, folic acid - 4.6 ng/mL. The mean value of carnitine and folic acid are almost low value. Conclusions: Thiamine, carnitine, folic acid deficiency are common in epilepsy patients. Especially carnitine and folic acid levels are significantly low. These suggest supplementation of these are therapeutic values for preventing epileptic seizure and complications. The deficiency of thiamine, carnitine, or folic acid may imply epilepsy; diagnostic tools. Now is the era of re-evaluation of thiamine, carnitine, folic acid. Funding: No funding