Vitamin B₁₂ Deficiency in Children With Infantile Spasms: A Case-Control Study

There have been few case reports showing association of vitamin B₁₂ deficiency with infantile spasms. We planned this study to see if there was an association of serum vitamin B₁₂ deficiency in children with development of infantile spasms. Cases included children with infantile spasms of ages 6 months to 3 years. The controls were children in the same age group who had global developmental delay but no history of epileptic spasms. Mean serum vitamin B₁₂, serum homocysteine, and urinary methylmalonic acid levels were measured in both groups and compared. Children with infantile spasms had lower mean serum vitamin B₁₂ levels (354.1 pg/mL; standard deviation 234.1 pg/mL) as compared to children with global developmental delay without spasms (466.7 pg/mL; standard deviation 285.5 pg/mL) ( P value < .05). Mean serum homocysteine level (13.9 vs 7.8 μmol/L, P = .02) and mean urinary methylmalonic acid level (68.1 mmol/mol of creatinine vs 26.1 mmol/mol of creatinine, P = .03) were elevated in children with infantile spasms than in controls. Fourteen children (35.0%) with infantile spasms were vitamin B₁₂ deficient compared with 3 (7.50%) controls ( P = .005). Thus, vitamin B₁₂ deficiency may have an association with infantile spasms. More studies are needed before recommending routine measurement of serum B₁₂ levels in children with infantile spasms.