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Related Concept Videos

Antiepileptic Drugs: GABAergic Pathway Potentiators01:18

Antiepileptic Drugs: GABAergic Pathway Potentiators

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γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
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Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein01:20

Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein

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Antiepileptic drugs, such as levetiracetam (Keppra) and brivaracetam (Briviact), have emerged as crucial tools in managing epilepsy. These medications exert their therapeutic effects by targeting the synaptic vesicle protein SV2A, a transmembrane glycoprotein primarily found in the brain.
SV2A is a transmembrane glycoprotein located predominantly in the brain, modulating the release of neurotransmitters for neuronal communication. Both levetiracetam and brivaracetam exhibit a high affinity for...
314
Antiepileptic Drugs: Potassium Channel Activators01:20

Antiepileptic Drugs: Potassium Channel Activators

186
Ezocgabine or retigabine, an antiepileptic drug of remarkable efficacy, has revolutionized the management of seizures. It is a potassium channel activator, explicitly targeting the family of Q subtype potassium channels. It enhances the transmembrane potassium currents, regulating neuronal excitability. This action stabilizes the resting membrane potential, a pivotal factor in mitigating the hyperexcitability that characterizes epilepsy.
Ezogabine has gained approval as an adjunctive treatment...
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Antiepileptic Drugs: Glutamate Antagonists01:14

Antiepileptic Drugs: Glutamate Antagonists

376
Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
376
Antiepileptic Drugs: Sodium Channel Blockers01:08

Antiepileptic Drugs: Sodium Channel Blockers

592
Antiepileptic drugs are specialized medications that prevent seizures in individuals diagnosed with epilepsy. These drugs primarily function by blocking the movement of sodium ions through channels in the neuronal membrane, inhibiting the repetitive firing of action potentials often associated with seizures.
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
592
Antiepileptic Drugs: Calcium Channel Blockers01:17

Antiepileptic Drugs: Calcium Channel Blockers

414
Calcium channel blockers, a class of antiepileptic drugs, regulate the flow of calcium ions within neurons.
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
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Related Experiment Video

Updated: Jul 9, 2025

Microdialysis of Excitatory Amino Acids During EEG Recordings in Freely Moving Rats
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Valproate-Induced Hyperammonemic Encephalopathy Causing New-Onset Seizures.

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  • 1Internal Medicine, Parkview Medical Center, Pueblo, USA.

Cureus
|November 29, 2023
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Summary

Valproate-induced hyperammonemic encephalopathy (VHE) is a rare side effect of valproic acid. This condition can cause confusion and neurological symptoms even with normal valproate levels, necessitating careful patient monitoring.

Keywords:
encephalopathyhyperammonemiahyperammonemia-encephalopathyphelan-mcdermidseizureurea cyclevalproate inducedvalproate toxicityvalproic acidvalproic acid toxicity

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Area of Science:

  • Neurology
  • Toxicology
  • Pharmacology

Background:

  • Valproic acid (VPA) is a widely used antiepileptic and mood-stabilizing drug.
  • Valproate-induced hyperammonemic encephalopathy (VHE) is a rare but serious adverse effect of VPA therapy.
  • VHE can occur despite therapeutic VPA serum levels and normal liver function.

Observation:

  • A 19-year-old male with bipolar disorder on daily VPA presented with new-onset seizures.
  • Laboratory tests revealed elevated blood ammonia levels despite therapeutic VPA concentrations.
  • The patient exhibited impaired consciousness and focal neurological symptoms.

Findings:

  • Discontinuation of VPA led to the resolution of hyperammonemia and neurological symptoms.
  • The case highlights that VHE can manifest even with normal VPA dosing and without hepatic dysfunction.
  • Accumulation of toxic VPA metabolites and subsequent ammonia increase are implicated in VHE pathogenesis.

Implications:

  • VHE should be considered in the differential diagnosis of altered mental status in patients receiving VPA.
  • Awareness of VHE is crucial for clinicians managing patients on VPA therapy.
  • Further research into the mechanisms and risk factors of VHE is warranted to improve patient safety.