Abstract:
BACKGROUND:Valproate (VPA) is an antiepileptic drug with a broad spectrum of efficacy. Although usually well-tolerated, it may have side-effects of which encephalopathy is one of the most serious. OBJECTIVE:To describe the clinical characteristics of valproate encephalopathy (VE) in five older patients with remote symptomatic seizures treated with rapid VPA loading. DESIGN:Case series. SETTING:Teaching hospital PATIENTS:Five patients (71-89 years old) with underlying cerebrovascular disease or dementia and symptomatic seizures. RESULTS:VE was characterised by decline in conscious level and (in some cases) increase in seizure frequency. Three of the five patients had elevated ammonia levels. EEG showed generalised slow activity, in some cases accompanied by additional epileptic discharges. The condition was reversible in four patients after VPA discontinuation. One patient died. CONCLUSIONS:Older people may be at particular risk of VE because of co-morbid pathology, age-related metabolic changes and co-medication.
journal_name
Age Ageingjournal_title
Age and ageingauthors
Beyenburg S,Back C,Diederich N,Lewis M,Reuber Mdoi
10.1093/ageing/afm019subject
Has Abstractpub_date
2007-05-01 00:00:00pages
344-6issue
3eissn
0002-0729issn
1468-2834pii
afm019journal_volume
36pub_type
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