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Valproate-induced hyperammonemic encephalopathy with normal liver function.

Amitav Rath1, T Jaishree Naryanan, G V S Chowdhary

  • 1Department of Neurology, The Institute of Neurological Sciences, CARE Hospital, Hyderabad, India.

Neurology India
|July 13, 2005
PubMed
Summary
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Valproate therapy can cause hyperammonemic encephalopathy, a serious side effect. Promptly suspecting and treating this condition in epilepsy patients on valproate with altered sensorium leads to clinical improvement.

Area of Science:

  • Neurology
  • Clinical Pharmacology
  • Toxicology

Background:

  • Hyperammonemic encephalopathy is an uncommon but serious adverse effect of valproate therapy.
  • This condition can occur even with normal liver function.

Purpose of the Study:

  • To analyze cases of hyperammonemic encephalopathy in epilepsy patients treated with valproate.
  • To identify risk factors and clinical features associated with valproate-induced hyperammonemic encephalopathy.

Main Methods:

  • Retrospective analysis of case records of 5 epilepsy patients.
  • Review of valproate dosage, duration of therapy, and concomitant medications.

Main Results:

  • Alteration in sensorium was the primary clinical presentation.

Related Experiment Videos

  • Identified risk factors included high initial dose, long-term valproate use, and concomitant topiramate.
  • A strong correlation was observed between decreased serum ammonia levels and clinical improvement.

    • Conclusions:

    • Hyperammonemic encephalopathy should be suspected in valproate-treated patients presenting with altered sensorium.
    • Early diagnosis and treatment of this condition result in favorable clinical outcomes.