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A Case of Valproate Induced Hyperammonemic Encephalopathy
Joint Authors
Slee, Mark
Tarafdar, Surjit
Ameer, Faisal
Doogue, Matt
Source
Issue
Vol. 2011, Issue 2011 (31 Dec. 2011), pp.1-2, 2 p.
Publisher
Hindawi Publishing Corporation
Publication Date
2011-05-04
Country of Publication
Egypt
No. of Pages
2
Main Subjects
Abstract EN
A 36-years-old man on phenytoin, levetiracetam, and sodium valproate presented with acute confusion.
Routine investigations including serum valproate and phenytoin concentration were normal.
His serum ammonia concentration was raised.
His valproate was held and 2 days later he recovered with concordant normalisation of serum ammonia concentration.
Urea acid cycle disorder was ruled out, and a diagnosis of valproate induced hyperammonemic encephalopathy (VHE) was made.
Asymptomatic hyperammonemia occurs in 15–50% of valproate-treated patients, and while the true incidence of VHE is not known, it is a recognized complication of sodium valproate treatment.
VHE typically presents acutely with impaired consciousness, lethargy, and vomiting.
Valproate concentrations may be in the therapeutic range, and liver function tests are typically “normal.” Treatment for VHE consists of ceasing valproate and providing supportive care.
Some have advocated carnitine replacement.
American Psychological Association (APA)
Tarafdar, Surjit& Slee, Mark& Ameer, Faisal& Doogue, Matt. 2011. A Case of Valproate Induced Hyperammonemic Encephalopathy. Case Reports in Medicine،Vol. 2011, no. 2011, pp.1-2.
https://search.emarefa.net/detail/BIM-512282
Modern Language Association (MLA)
Tarafdar, Surjit…[et al.]. A Case of Valproate Induced Hyperammonemic Encephalopathy. Case Reports in Medicine No. 2011 (2011), pp.1-2.
https://search.emarefa.net/detail/BIM-512282
American Medical Association (AMA)
Tarafdar, Surjit& Slee, Mark& Ameer, Faisal& Doogue, Matt. A Case of Valproate Induced Hyperammonemic Encephalopathy. Case Reports in Medicine. 2011. Vol. 2011, no. 2011, pp.1-2.
https://search.emarefa.net/detail/BIM-512282
Data Type
Journal Articles
Language
English
Notes
Includes bibliographical references
Record ID
BIM-512282