Methylenetetrahydrofolate Reductase Deficiency in Ischemic Stroke
Methylenetetrahydrofolate Reductase Deficiency in Ischemic Stroke
Adult onset epileptic seizures is rare and often associated with metabolic disorders, drugs
 and intracranial pathologies such as ischemia, hemorrhage or space-occupying lesions.
 Methylenetetrahydrofolate reductase (MTHFR) deficiency is one of the reasons that cause
 epileptic seizures in adults and can be ignored. MTHFR deficiency is an autosomal recessive
 disorder that results in hyperhomocysteinemia and causes a predisposition to venous and
 arterial thrombosis. The incidence of the polymorphism is around 40% in some countries. The
 aim of the retrospective study is to investigate the incidence of MTHFR deficiency in
 patients with adult-onset epileptic seizures.
Epileptic seizures that begin in adulthood seriously affect patients, their relatives and the
 society in which they live financially and psychologically. The etiology of epileptic
 seizures starting at adult age includes head trauma, central nervous system infections,
 intracranial lesions, cerebrovascular events, metabolic diseases and drugs. While the causes
 of childhood epileptic seizures are generally considered idiopathic, adult-onset epileptic
 seizures are almost always due to a pathological process. Epileptic seizures in adults may be
 a symptom of ischemic stroke. MTHFR deficiency is associated with raised homocysteine
 concentration in the body and increased risk of stroke (1). Studies have demonstrated that
 hyperhomocysteinemia is an independent risk factor for stroke (2).

 MTHFR is the key enzyme in remethylation of homocysteine to methionine. MTHFR deficiency is
 an autosomal-recessive disease characterized by high homocysteine and low or normal
 methionine. MTHFR deficiency can cause vascular thrombosis in adults at early age; increased
 osteoporosis in elderly people; deep vein thrombosis, abortus during pregnancy; and
 infertility in adult males. In children, it is associated with intrauterine growth
 retardation, congenital heart diseases, neural tube defects, chromosome anomalies and
 hematologic tumors. In any age group, it might cause convulsions, increased thrombosis risk
 with some anticonvulsants and with the use of nitrogen protoxide in surgeries, and neuromotor
 retardation (3).

 The aim of this retrospective study is to investigate the incidence of MTHFR deficiency in
 patients presenting with adult-onset epileptic seizures and diagnosed as ischemic
 cerebrovascular disease as a result of diagnostic tests.
Inclusion Criteria:

 -  The patients with adult-onset epileptic seizures and diagnosed ischemic stroke in 3
 years period.

 Exclusion Criteria:

 -  Pediatric patients with epileptic seizures