New Onset Medically Refractory Seizures in an Adult With Parkinson's Disease and Vitamin B6 Deficiency Case Report.

Background: The association between Parkinson's disease and epilepsy remains unclear. A higher proportion of patients with Parkinson's disease who have experienced seizures had at least one episode of status epilepticus compared to healthy controls. It is crucial to distinguish whether seizures are provoked or unprovoked as this changes the long-term treatment plan and prognosis.

Case presentation: We report a case of new onset seizures refractory to multiple anti-seizure medications in a patient with Parkinson's disease in the context of vitamin B6 deficiency. The seizures started after a recent increase in carbidopa/levodopa dose. Seizures resolved with pyridoxine supplementation. The patient was able to successfully wean off all anti-seizure medications without any further seizures and had incomplete normalization of EEG.

Practical implications: Clinicians should consider vitamin B6 deficiency as an etiology for new-onset refractory seizures in patients with Parkinson's disease on carbidopa/levodopa. Repletion of vitamin B6 can be curative, and patients may ultimately not require long term anti-seizure medications.