Case: Valproat-Induced Hyperammonemic Encephalopathy

Valproate induced hyperammonemic encephalopathy (VHE) is a severe adverse effect of medicine. An epileptic patient with an acute hyperammonemia after the addition of valproic acid to his treatment presented with acute mental status changes consistent with encephalopathy. Notably, plasma ammonia leve...

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Bibliographic Details
Published inGazi tıp dergisi Vol. 27; no. 2
Main Authors Arhan,Ebru Petek, Demir,Ercan, Ünlüsoy Aksu,Aysel, Özçelik,Ayşe Aysima
Format Journal Article
LanguageEnglish
Published Gazi Üniversitesi Yayınları 01.01.2016
Subjects
Sağlık Hizmetleri
Tıp
Ankara
Türkiye
toxicity
karnitin
Valproat
hiperamonemi
transaminazlar
ensefalopati
toksisite
hyperammonemia
carnitine
transaminases
encephalopathy
Valproate
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Summary:Valproate induced hyperammonemic encephalopathy (VHE) is a severe adverse effect of medicine. An epileptic patient with an acute hyperammonemia after the addition of valproic acid to his treatment presented with acute mental status changes consistent with encephalopathy. Notably, plasma ammonia level was 2 times of the upper limit, despite normal liver function tests. Plasma valproic acid level was in the therapeutic range. His symptoms resolved with the discontinuation of valproic acid and L- carnitine administration. We discuss this case and review the possible mechanisms of valproic acid-associated encephalopathy and the efficacy of L-carnitine.
ISSN:2147-2092
2147-2092
DOI:10.12996/gmj.2016.27