Results
INDICATIONS
Diagnosis and treatment of pyridoxine-dependent seizures. The test dose of pyridoxine to confirm diagnosis of PDS is not well established. The consensus is that diagnosis of PDS is confirmed when high doses of pyridoxine achieve complete seizure control that has been resistant to traditional antiepileptics. Pyridoxine and antiepileptics are then withdrawn, followed by a reoccurrence of clinical seizures that are, again, successfully treated with pyridoxine monotherapy.
ADVERSE EFFECTS
There have been reports of prolonged depression of neurologic and respiratory function, as well as depression of cerebral electrical activity when given either orally or IV. Cardiorespiratory monitoring is recommended and ventilator support may be necessary with initial administration of pyridoxine. When given IV, there have been reports of bradycardia, apnea, and hypotension. Pyridoxine injection contains aluminum that may be toxic with prolonged IV administration in patients with renal impairment or in premature infants (immature kidney function).
MONITORING
When possible, initial administration of pyridoxine should be accompanied by EEG monitoring. Monitor for cardiorespiratory depression. Monitor for signs of peripheral neuropathy with long-term use. A pyridoxine level than less 20 nanomoles/L is indicative of deficiency.