간질에서의 Homocyteine의 중요성
The Significance of Homocysteine in Epileptic Patients
김옥준, 김남근, 김현조, 서정호, 이규용, 안정용, 오도연, 김세현,
소속 상세정보
김옥준 ( Kim Ok-Joon )
포천중문의과대학교 신경과학교실
김남근 ( Kim Nam-Keun )
포천중문의과대학교 임상의학연구소
김현조 ( Kim Hyun-Jo )
포천중문의과대학교 신경과학교실
서정호 ( Seo Jung-Ho )
포천중문의과대학교 신경과학교실
이규용 ( Lee Gue-Yong )
포천중문의과대학교 신경과학교실
안정용 ( Ahn Jung-Yong )
포천중문의과대학교 임상의학연구소
오도연 ( Oh Do-Yeun )
포천중문의과대학교 임상의학연구소
김세현 ( Kim Se-Hyun )
포천중문의과대학교 예방의학교실
KMID : 0877220020060010020
Abstract
Purpose: Hyperhomocysteinemia was observed in epileptic patients receiving anticonvulsants, especially homozygotes for mtehylenetetrahydrofolate reductase (MTHFR) gene 677C->T mutation. Hyperhomocysteinemia induce atherosclerosis, fetal anticonvulsant syndrome, etc. Therefore, we examined any other factors that might affect the level of homocysteine in epileptic patients.
Methods: We investigated the plasma total homocysteine level in 145 patients with epilepsy. And then we analyzed various factors (clinical findings, neuro-image finding, drugs, MTHFR gene, serum folate and vitamin B12 level) affecting the level of homocysteine.
Results: Among the various factors, male, present neurological deficits, frequent seizure attacks, MTHFR gene 677 TT genotype, polypharmacy, and conventional drug (phenytoin, carbamazepine, valproic acid, phenobarbital, primidone, benzodiazpines) than new drug (lamotrigine, vigabatrin, topiramate, oxcarbazepine zonisamide) were related with elevated homocysteine levels.
Conclusion: We recommend monotherapy with new drugs and higher vitamin requirement in the male epileptic patients of MTHFR TT genotype with neurological deficits and frequent seizure attacks.
키워드
Homocysteine; Drug; MTHFR gene; Neurological deficits
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