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Reversible central nervous system dysfunction in folate deficiency.

E Melamed, A Reches, C Hershko

    Journal of the Neurological Sciences
    |May 1, 1975
    PubMed
    Summary
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    Anticonvulsant therapy can lead to folate deficiency, causing anemia and neurological issues like dementia. Prompt folic acid treatment reversed these symptoms in an epileptic patient, highlighting the importance of monitoring folate levels.

    Area of Science:

    • Neurology
    • Hematology
    • Clinical Pharmacology

    Background:

    • Epileptic patients often undergo long-term anticonvulsant drug therapy.
    • Anticonvulsant medications can interfere with nutrient absorption and metabolism.
    • Folate deficiency is a potential complication of certain drug therapies.

    Observation:

    • A patient on chronic anticonvulsant treatment developed anemia and neurological deficits.
    • Symptoms included progressive dementia, pyramidal tract signs, incontinence, and ataxia.
    • Vitamin B12 levels were normal, but serum folic acid levels were low.

    Findings:

    • Oral folic acid administration effectively resolved both the anemia and neurological disturbances.
    • The patient's neurological syndrome appeared transient and directly related to folate deficiency.

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    Implications:

    • This case suggests a direct causal link between folate deficiency and neurological impairment in patients on anticonvulsants.
    • Regular monitoring of folate levels is crucial for epileptic patients on long-term anticonvulsant therapy.
    • Folic acid supplementation may prevent or treat these adverse effects.