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Valproate induced hyperammonemic encephalopathy successfully treated with levocarnitine.

Andrea Rigamonti1, Giuseppe Lauria2, Gianluca Grimod3

  • 1Department of Neurology, Alessandro Manzoni Hospital, Via Dell'Eremo 9/11, 23900 Lecco, Italy.

Journal of Clinical Neuroscience : Official Journal of the Neurosurgical Society of Australasia
|October 15, 2013
PubMed
Summary

Valproate-induced hyperammonemic encephalopathy is a rare adverse effect of valproate treatment. This case report highlights successful treatment with levocarnitine, offering a potential therapeutic option.

Keywords:
EncephalopathyHyperammonemiaLevocarnitineValproic acid

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Area of Science:

  • Neurology
  • Pharmacology
  • Toxicology

Background:

  • Valproate is a widely used antiepileptic and mood-stabilizing drug.
  • Hyperammonemic encephalopathy is a rare but serious adverse effect associated with valproate therapy.
  • This condition can occur even at therapeutic drug levels.

Observation:

  • A patient developed valproate-induced hyperammonemic encephalopathy after a brief treatment course.
  • The patient presented with acute neurological symptoms including impaired consciousness and increased seizure frequency.
  • The condition was successfully managed with levocarnitine administration.

Findings:

  • Levocarnitine effectively resolved the hyperammonemic encephalopathy in the reported case.
  • Literature review supports levocarnitine as a potential treatment for valproate-induced hyperammonemia.
  • Early recognition and intervention are crucial for managing this adverse effect.

Implications:

  • Levocarnitine should be considered in the management of valproate-induced hyperammonemic encephalopathy.
  • This finding may guide clinical practice in patients experiencing adverse effects from valproate.
  • Further research into the mechanism and efficacy of levocarnitine in this context is warranted.