Pyridoxine dependent seizure have been recognized as a rare and important cause of intractable seizure in neonates and infants. patient with this autosomal recessive disorder have recurrent seizures that are resistant to conventional anti convulsants but respond dramatically to intravenous or intermuscular administration of pyridoxine.The patient was 2 days old neonat who was refered to Amiralmomenin ali hospital because of recurrent seizures .all paraclinical studies were in normal ranges . the seizure was resistant to the conventional anti convulsant but after 100 mg of pyridoxine by intravenous injection it stopped dramatically.

Pyridoxine dependent seizures have been recognized as a rare and important cause of intractable seizures in neonates and infants. Prompt diagnosis and treatment can stop and prevent these seizures and consequential developmental disabilities. Furthermore it can eliminate the unnecessary administration of anticonvulsant medications and their side effects. The patient was 7 months old infant who was refered to Imam Reza hospital because of recurrent seizures. All para clinical studies including BS, calcium, serum Ammonium were within normal limits. Electroencephalography was indicative of hypsarrhythemia and cerebral CT scan was normal. The seizure was resistant to the current treatments. However it was stopped after the administration of B6.

Vitamin B6 (pyridoxine) dependent seizure (PDS) is an autosomal-recessively inherited disorder which starts within a few hours of birth or even earlier, and can cause intrauterine seizures[1,2]. It occurs while the serum level of B6 vitamin is normal.

Background: despite high prevalence rate of nausea vomiting and mead for treatment in severe cases which leads to electrolyte imbalances and weight loss, due to lack of knowledge about its cause, an elear-cut treatment for it, is still unavailable. In this study we compared the effect of prednisolone to that of pyridoxine on the treatment of severe cases of vomiting during the first half of pregnancy. Methods and Materials: In a double blind clinical trial study (2002-2003) 120 women with a normal intra uterine pregnancy and less than 22 weeks of gestational age with hyper emesis gravidarum were admitted to Zahedan Qhods hospital for appropriate treatment. Patients randomly divided in two groups of 60; patients, received prednisolone 5mg /TDS (case group) and the other 60 patients, received pyridoxine / 20mg/ TDS (control group). 3 days later, serum electrolytes, severity of vomiting, beginning of diet, and response to treatment were studied. All patients were followed every week, up to 22 weeks of gestational age. Results: There was no significant difference between the two groups with respect to maternal age, gestational age, and gravidity, and weight loss, number of previous admissions recent pregnancy. There was significant difference between the two groups in electrolyte disorders, start of feeding after 1-2 days from initiated treatment, recurrent admission 2 weeks after discharge and response to treatment (P≤ 0.001).90% of the patients in prednisolone group and 61.7% of pyridoxine group responded positively to the treatment. 3 days after the commencement of the treatment, 18 people in prednisolone group and 5 in pyridoxine still had electrolyte imbalances. The proportion of vomiting and hypocalemi modification in prednisolone consumer were, respectively consumer 4.5 and 4.7 as much as pyriodoxine and the likeliyhood of the relapse of vomiting in pyridoxine consumer was 3.3 as much as prednisolone. Conclusions: A short course of a little prednisolone therapy was more effective than pyridoxine in treatment of hyper emesis gravidarum.

Intractable epilepsy is a common clinical problem in pediatrics and approximately 13% of children with epilepsy experience intractable seizures. To determine the efficacy of pyridoxine in treating seizures, 30 infants and children with recurrent seizures were enrolled in the present study. All of them were treated with high-dose oral pyridoxine (40 mg/kg/day), as an adjunct to antiepileptic drugs. Clinical efficacy criteria were based on the daily frequency of seizures after therapy was initiated during the following three weeks. The results indicated that the mean frequency of seizures decreased significantly from the first (l6.2±11) to the fourth visit (7±6.2) (p<0.001, t=4). Three patients became completely seizure free. No adverse effects of pyridoxine were apparent during the observation period. We conclude that pyridoxine is a safe, effective, and well-tolerated adjunct to routine antiepileptic drugs for the treatment of recurrent intractable seizures in children.

Background and Objective: Refractory seizure is a rare manifestation of INH poisoning. We report a case INH poisoning with refractory seizure.Case presentation: A 17-year old male referred to our emergency room with seizure. Antiepileptic treatment with diazepam was ordered and repeated doses were prescribed. His family reported that he ingested 4.5 gram INH about 2 hours ago. He was admitted to ICU. Despite frequent doses of diazepam, he went into status epilepticus. Pridoxine was administered intravenously 200 mg/qid for 3 days Status epilepticus was terminated after pyridoxine administeration. He was discharged from hospital after 4 days without any neurological sequel.Discussion: We reported here a case of INH poisoning with refractory seizure. In this setting pyridoxine helped to terminate status epilepticus.

Introduction & Objective: Nausea and vomiting in early pregnancy are common symptoms which are a great burden either economically or psychologically on the pregnant women and her family. Considering the fact that, pregnant women do not seek appropriate medical treatment because of their concern of drug's side effects on fetus; it would be useful to administrate vitamins, which are accepted as safe drugs, for the first line treatment. Our Purpose was to determine the effectiveness of Pyridoxine for nausea and vomiting of pregnant women with less than 16 weeks of gestational age.Materials & Methods: During the winter of 2006, 70 pregnant women with less than 16 weeks of gestational age, who had attended a private clinic and four urban Health Centers in Rasht, were randomly divided in to two groups to receive either oral Pyridoxine 40 mg per day or placebo during five days, in a double- blind fashion. Patients graded the severity of their nausea by a visual analog scale over 24 hours before the treatment and then during the five days of treatment. They also recorded the number of vomiting episodes over the previous 24 hours before the treatment and during the five days of treatment. Data was analyzed by t-test, ANCOVA, ordered logistic regression, chi-square, Mann-Witney and Wilkoxon tests.Results: There was a significant decrease in the mean of post therapy minus baseline nausea score in the pyridoxine group compared with that in the placebo group (P=0.019 - ANCOVA). There was also a greater reduction in the mean number of vomiting episodes in the pyridoxine group (P=0.042 - Mann witney test).Conclusions: Pyridoxine is effective in decreasing nausea and vomiting in early pregnancy and it can be administrated 40 mg per day during 3 to 4 days.