LAUSR

Annals of Indian Academy of Neurology ¦ Volume 25 ¦ Issue 6 ¦ November-December 2022 1241 enzymatic action into active 5‐methyltetrahydrofolate which enters the CSF through a reduced folate carrier.[12] With the administration of folinic acid, a rise in serum folate has been observed in patients with HFM while normalizing CSF folate levels was difficult.[12] Folic acid should be avoided in patients with HFM as it binds to the folate receptor in the choroid plexus and interferes with the transport of 5‐methyltetrahydrofolate into the CSF.[5] Reversal of hematological and gastrointestinal manifestations and immune dysfunction has been documented after treatment but a reversal of neurological consequences may be difficult.[13] To conclude, the diagnosis of HFM should be considered in children with psychomotor delay and seizures with the involvement of other systems including hematological, gastrointestinal, or immunological systems.