a complicated case of stroke, epilepsy, and mood disorder: hyperhomocysteinemia or medication cascade

Introduction: hyperhomocysteinemia is a risk factor for atherosclerosis and vascular disease, which is correlated with cerebral problems and various neurological disorders. case presentation: we report a 20-year-old lady with a history of hyperhomocysteinemia affected with stroke, seizure, and mood disorder. by initiating medication for these illnesses, different complications appeared. during the hospital stay, drugs for treating a disease deteriorated the other. we encountered a complex patient and numerous ambiguities in her management. conclusions: for patients with elevated serum homocysteine and psychiatry disorders, it is important to consider mthfr gene mutation. a challenge in these patients is to select the medication that does not deteriorate hyperhomocysteinemia. in this complex case, we used carbamazepine that was accompanied by clinical improvement.