Pyridoxine-dependent convulsions in an infant.

The association of dietary pyridoxine deficiency and convulsions was first noted in animal experiments by Chick, El Sadr and Worden (1940). An analogous situation in humans was recognized when Snyderman, Carretero and Holt (1950) described the onset of seizures in a mentally retarded child whose diet lacked this vitamin. Shortly afterwards, an outbreak of convulsions in young infants in the United States was shown to be due to the low pyridoxine content in their diet (Coursin, 1954; Molony, 1954; Bessey, Adam, Bussey and Hansen, 1954; Adam, Bessey, Bussey and Hansen, 1954; May, 1954). An association of a different category was first recorded when Hunt, Stokes, McCrory and Stroud (1954) described the case of an infant who began to suffer from seizures a few hours after birth. Pyridoxine in high doses abolished the attacks, and the term 'pyridoxine dependency' was used to describe this situation in which convulsions are of early onset and dietary deficiency cannot be invoked. Only three other reports have been encountered (Bessey, Adam and Hansen, 1957; Marie, Hennequet, Lyon, Debris and Le Balle, 1959; Scriver, 1960) describing infants whose attacks similarly responded to pyridoxine therapy. The case reported here seems to fulfil the criteria for its acceptance as a further instance of convulsions associated with a state of pyridoxine dependency.