2001 Volume 47 Issue 3 Pages 181-187
Folic acid (folate) levels were measured in the serum of patients with various neurological diseases in Japan. Thirty-six patients showed decreased serum folate levels among 343 consecutive neurological patients (10.5%). Folate administration (15 mg/d) to folate-deficient patients improved neurological symptoms in 24 of 36 cases (67%). Serum folate levels were significantly lower in female than in male folate-deficient patients. Folate-deficient patients showed predominantly axonal neuropathy, which responded to folate sup-plementation more markedly. Male patients more frequently exhibited neuropathy, espe-cially demyelinating and motor-dominant neuropathy, than females. Anemia was corre-lated with male sex and low serum folate levels. Male patients were more responsive than fe-males to folate treatment. More male patients had taken excess alcohol or received gastrec-tomies than females. Neurological symptoms were more frequently improved by folate sup-plementation in patients with neuropathy than exclusive encephalopathy. Serum folate lev-els were lower in patients with encephalopathy, especially those with dementia, while folate therapy was more effective in neurological patients without dementia. Dysgeusia and ane-mia improved in all patients after folate administration. Neurological patients with malab-sorption or treated with continuous drip infusion were resistant to folate therapy. Since fo-late-responsive neuroencepahlopathies are not rare among patients with neurological dis-eases in Japan, the serum folate level would serve as a valuable indicator for folate supple-ment therapy.
