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[Valproate-associated hyperammonemic encephalopathy. Report of one case]
Pablo Young1, Bárbara C Finn, Florencia Alvarez
1Servicios de Clínica Médica y Nefrología, Hospital Británico de Buenos Aires, Perdriel 74, Argentina. pabloyoung2003@yahoo.com.ar
Revista Medica De Chile
|February 9, 2008
Summary
Valproate medication can cause hyperammonemic encephalopathy, a reversible condition affecting brain function. Prompt diagnosis and treatment, including discontinuing valproate, are crucial for patient recovery.
Area of Science:
- Neurology
- Clinical Pharmacology
Background:
- Valproate is an anticonvulsant medication.
- Hyperammonemic encephalopathy is a serious neurological condition.
Observation:
- A 78-year-old female patient on valproate experienced recurrent episodes of altered sensorium.
- Initial investigations including laboratory tests, imaging, and EEG were inconclusive.
Findings:
- Elevated blood ammonia levels (123 microg/dl) were detected, indicating hyperammonemia.
- Discontinuation of valproate and treatment with lactulose and L-carnitine led to complete recovery within 48 hours.
Implications:
- Valproate-induced hyperammonemic encephalopathy is a potentially fatal condition that may be underdiagnosed.
- A high index of suspicion is necessary for prompt diagnosis and management of this reversible neurological complication.
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