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Reversible altered consciousness with brain atrophy caused by valproic acid
Hideo Yamanouchi1, Takako Ota, George Imataka
1Department of Pediatrics, Dokkyo University School of Medicine, 880 Kitakobayashi, Mibu, Shimotsuga, Tochigi 321-0293, Japan.
Pediatric Neurology
|July 25, 2003
Summary
Valproic acid, used for epilepsy, can cause a rare side effect of temporary altered consciousness and brain atrophy in children. Symptoms resolved after discontinuing the medication.
Area of Science:
- Neurology
- Pediatric Neurology
- Clinical Toxicology
Background:
- Valproic acid is a widely used antiepileptic drug for managing various seizure disorders.
- Localization-related epilepsy requires long-term treatment, often involving valproic acid.
- Adverse effects of antiepileptic drugs necessitate continuous monitoring and evaluation.
Observation:
- A 5-year-old female patient experienced altered consciousness during valproic acid therapy for epilepsy.
- Cerebral atrophy and slow electroencephalography (EEG) background activity were observed via CT and EEG.
- Neurological status and brain imaging normalized after valproic acid cessation.
Findings:
- The patient's altered consciousness and cerebral atrophy were reversible, resolving within weeks.
- This clinical presentation is identified as a rare, idiosyncratic adverse reaction to valproic acid.
- The rapid onset and resolution suggest a direct, albeit unusual, effect of the drug on brain structure and function.
Implications:
- Highlights the importance of recognizing rare adverse drug reactions in pediatric epilepsy management.
- Suggests careful consideration of valproic acid in cases of unexplained neurological changes.
- Emphasizes the need for prompt discontinuation of the offending agent to ensure patient recovery.