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S-Adenosylmethionine: molecular, biological, andclinical aspects--an introduction. Focal neurologic defi cits, raisedICP, and seizures are absent, but some encephalopathymay be present, particularly in the elderly patient. Metabolism may be described as occurringthrough a linear (first-order) pathway using a rate constant(k :h?1) or a saturable (Michealis–Menten) pathway withcapacity Vmax (mg/h) and affinity Km (mg/l). In some instances, neural compensation could actlike a cane, which enables individuals to walk but willnot return the ability to sprint. Her dizziness and vertigo are more marked whensitting from lying position and on standing. Impaired synthesis of Cys from methionine may necessitatethe provision of a source of Cys to some patients with cirrhosis; however, supplementationwith L-Cys could lead to hypercysteinemia and potential toxicity.
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