Non-convulsive status epilepticus secondary to valproic acid-induced hyperammonemic encephalopathy.

Abstract:

BACKGROUND:Valproic acid (VPA) may induce hyperammonemic encephalopathy. On the other hand, seizure-inducing effects of antiepileptic drugs (AEDs) may be a paradoxical reaction or a result of AED-induced encephalopathy (commonly induced by VPA). METHODS:We present the case of a 19-year-old male who developed acute mental status changes consistent with encephalopathy evolving into repetitive seizures with oral automatisms induced by relatively small doses of VPA. RESULTS:Although serum hepatic enzymes, such as AST and ALT, were normal, serum ammonia concentration was high, i.e. 70 micromol/l (normal range 9-33 micromol/l). Administration of VPA was discontinued immediately after admission. The patient's condition improved during the second week of hospitalization and ammonium levels returned to normal. CONCLUSION:In conclusion, although uncommon, a possible induction of non-convulsive status epilepticus by valproate-induced hyperammonemic encephalopathy should be taken into account and properly managed by discontinuation of the drug.

journal_name

Acta Neurol Scand

authors

Velioğlu SK,Gazioğlu S

doi

10.1111/j.1600-0404.2006.00793.x

subject

Has Abstract

pub_date

2007-08-01 00:00:00

pages

128-32

issue

2

eissn

0001-6314

issn

1600-0404

pii

ANE793

journal_volume

116

pub_type

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