Affiliation:
1. Arnold Brenne is with the Department of Pediatrics at Sinai Hospital in Baltimore and the Departmen of Medicine at Baltimore County General Hospital. Address: Arnold Brenner, MD. 8622 Librerty Plaza Mall. Randallstown. MD 21133.
Abstract
One hundred children with hyperkinesis and cerebral dysfunction were given individual three-day trials of pharmacologic doses of thiamin, calcium pantothenate, pyridoxine, and placebo. When beneficial response was noted, a second week-long trial of vitamins was given, alternating with placebo, followed by long-term therapy. Two-thirds of the remaining children not responding to this schedule were then given pharmacologic doses of niacinamide, combinations of B-complex vitamins, or elimination diets. Eight children dramatically responded to pharmacologic doses of thiamin, of which four still require the vitamin either intermittently or continuously after four years. Nine children responded to 300 mg of pyridoxine; an additional 5 patients responded only after receiving larger doses. Only one child could be maintained on placebo. In subsequent trials, 11 responded to niacin or to combinations of B-complex vitamins with minerals. In a two-year follow-up, six children who had demonstrated no beneficial response to these clinical trials had spontaneously improved. Eight children responded to dietary manipulations alone. Half the children found to be “dependent” on pharmacological doses of thiamin worsened with administration of B6. Conversely, half of the pyridoxine responders worsened when given large doses of thiamin. Blood zinc levels dropped substantially with administration of pyridoxine. The experience suggests that the hyperkinetic cerebral dysfunction syndrome is multifactoral. A significant number are caused by vitamin deficiency or pharmacologic dependency.
Subject
General Health Professions,Education,Health (social science)
Cited by
27 articles.
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