To investigate the influence of vitamin B supplementation on the plasma total homocysteine (Hcy), serum folate, serum vitamin B₁₂, serum vitamin B₆, and clinical state of senile epilepsy.

A total of 132 senile epilepsy patients with hyperhomocysteinemia, who visited the Second Affiliated Hospital of Soochow University from January 2013 to July 2015, were enrolled into this study. Eighty-three patients who accepted the therapy of vitamin B supplementation (folate 2.5 mg/d, vitamin B₆ 10.0 mg/d, vitamin B₁₂ 1.5 mg/d) were selected as treatment group, and 49 patients with no vitamin B supplementation were selected as control group. All patients were followed-up for one year. The differences of serum Hcy, folate, vitamin B₁₂, vitamin B₆ and seizure frequency, MMSE scores, Hamilton Depression Rating Scale (HDMA) scores between the treatment and the control groups were compared. According to the concentration of serum Hcy, 132 patients were divided into two groups: 75 patients (46 patients in the treatment group and 29 patients in the control group) with mild hyperhomocysteinemia (Hcy: 15.0-29.9 μmol/L), 57 patients (37 patients in the treatment group and 20 patients in the control group) with moderate-severe hyperhomocysteinemia (Hcy≥30.0 μmol/L). The differences of serum Hcy, folate, vitamin B₁₂, vitamin B₆ and seizure frequency, MMSE scores, HDMA scores between the treatment and the control group in the mild hyperhomocysteinemia group and in the moderate-severe hyperhomocysteinemia group were compared. And the influence factors of Hcy were analyzed.

Correlation analysis revealed that Hcy was positively correlated with age (r=0.269, P=0.002), and negatively correlated with folate (r=-0.222, P=0.010). Hcy was associated with smoking (χ²=7.363, P=0.007), hypertension (χ²=6.187, P=0.013), and two or more antiepileptic drugs polytherapy (χ²=4.708, P=0.030). After vitamin B supplementation in the group of moderate-severe hyperhomocysteinemia, serum Hcy concentration ((15.68±4.85) μmol/L in the treatment group vs (31.14±11.18) μmol/L in the control group, t=5.890, P<0.01), seizure frequency (4.85±2.78 vs 6.15±1.95, t=2.028, P=0.047) and HDMA scores (15.22±7.55 vs 17.70±4.90, t=2.862, P=0.005) decreased, whereas serum folate ((9.08±3.33) ng/ml vs (5.87±2.91) ng/ml, t=3.618, P=0.001), vitamin B₁₂ ((556.39±276.76) pg/ml vs (419.71±164.53) pg/ml, t=2.336, P=0.023), vitamin B₆ ((22.94±5.59) μmol/L vs (21.09±4.87) μmol/L, t=2.029, P=0.047) and MMSE scores (26.89±1.94 vs 25.75±2.20, t=2.024, P=0.048) increased in the treatment group compared with the control group. While in the group of mild hyperhomocysteinemia, the differences of seizure frequency, HDMA and MMSE scores were not statistically significant between the treatment group and the control group (all P>0.05).

It is necessary to monitor serum Hcy for senile epilepsy. Vitamin B supplementation is a safe and inexpensive way to reduce the concentration of Hcy, assist to control seizures and improve the clinical symptom of depression and cognitive impairment for senile epilepsy with moderate-severe hyperhomocysteinemia.

Epilepsy; Cysteine; Folic acid; Vitamin B₆; Vitamin B₁₂