Valproate-induced enuresis: a prospective study
Wissam R Yamak1, Ghassan Hmaimess2, Yamane Makke1
1Department of Neurology, American University of Beirut Medical Center, Beirut, Lebanon.
Insights
Secondary enuresis is a common side effect in children treated with valproate, often unreported but reversible. Age is a key predictor for this adverse event in pediatric epilepsy management.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Valproate is a widely used antiepileptic drug in children.
- Secondary enuresis is a potential adverse effect that may impact quality of life.
Purpose of the Study:
- To determine the incidence and characteristics of secondary enuresis in pediatric patients initiating valproate therapy.
- To identify factors associated with the development of valproate-induced enuresis.
Main Methods:
- Prospective study of 72 children (aged 5-12 years) diagnosed with epilepsy and treated with valproate.
- Systematic recording of adverse events, specifically inquiring about enuresis at follow-up visits.
Main Results:
- Secondary enuresis developed in 24% (17/72) of children, with onset after an average of 19.8 days.
- Age was the only significant predictor for enuresis development.
- Enuresis resolved in all cases upon valproate discontinuation and in most cases while continuing the medication.
Conclusions:
- Secondary enuresis is a frequent, often unreported, adverse event associated with valproate in children.
- The condition is generally reversible, highlighting the importance of monitoring.
- Age is a critical factor in predicting the risk of enuresis.
Aim:
The aim of this study was to determine the frequency and characteristics of secondary enuresis in children initiated on valproate treatment.
Method:
This was a prospective study conducted in children aged 5 to 12 years with suspected newly diagnosed epilepsy and maintained on valproate for at least 1 month. Adverse events spontaneously reported by parents were recorded at each follow-up visit. In addition, we specifically asked about enuresis and other side effects known to occur with valproate treatment. We assessed the frequency of enuresis and its association with a number of variables.
Results:
Seventy-two children (43 males and 29 females) with a mean age of 8 years 7 months (range 5-12y) were included in this study. Secondary enuresis developed in 17 (24%) of these children after, on average, 19.8 days of exposure to valproate. The data obtained from a multivariate analysis indicate that age was the only significant factor in predicting the development of enuresis. Enuresis ceased in all children after discontinuation of valproate use, and in 10 out of 11 children still on the drug.
Interpretation:
Secondary enuresis is a common adverse event associated with valproate use in children, which is not usually spontaneously reported and is reversible in most cases.
Related Concept Videos
01:29Urine Studies I: Urinalysis
01:20Physiology of the Genitourinary System III: Urine Concentration and Dilution
01:19Urodynamic Studies: Uroflowmetry
01:24Physiology of Urine Formation
Glomerular Filtration
The first stage in urine formation is glomerular filtration. Each kidney contains approximately 1 million nephrons, the functional units of filtration, with a...
01:23Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
A study on guinea pigs examined the...
01:30Urinary Tract Infection III: Diagnostic Studies and Interprofessional Care