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A Case of Valproate-Induced Hyperammonemic Encephalopathy
Faraaz Zafar1, Beau M Billadeau1, Ahsen U Ahmed1
1Internal Medicine, Gundersen Health System, La Crosse, USA.
Cureus
|August 14, 2020
Summary
Valproate medication can cause hyperammonemic encephalopathy, a serious condition affecting brain function. Discontinuing valproate and switching anti-seizure drugs resolved the patient's symptoms.
Area of Science:
- Neurology
- Clinical Toxicology
Background:
- Valproate is a widely used anti-seizure medication.
- Hyperammonemic encephalopathy is a rare but serious adverse effect of valproate therapy.
Observation:
- A 56-year-old male on long-term valproate presented with altered mental status, behavioral changes, and myoclonic jerks.
- Initial workup ruled out infection and acute metabolic abnormalities, but revealed markedly elevated ammonia levels and macrocytic anemia.
Findings:
- Valproate was identified as the causative agent for hyperammonemic encephalopathy.
- Discontinuation of valproate and initiation of an alternative anti-seizure medication led to the patient's recovery.
Implications:
- This case highlights the importance of considering valproate-induced hyperammonemic encephalopathy in patients with unexplained neurological symptoms.
- Awareness and prompt management are crucial for preventing severe neurological sequelae.
Keywords:
drug-related side effects and adverse reactionsneurologic complicationsside effects of medical treatmenttoxic encephalopathyMore Related Videos
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