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Hyperammonemic encephalopathy induced by valproic acid
Qiuyu M Zhu1, Amitosh K Singh2, Huai-En Rachel Chang2
1Internal Medicine, Kaiser Permanente Mid-Atlantic States, Gaithersburg, Maryland, USA martin.x.zhu@kp.org.
None:
Valproate (VPA) is broad-spectrum antiepileptic drug. Several adverse reactions including hepatotoxicity, fetal risk and pancreatitis are well known and labelled as boxed warnings in the USA. One adverse reaction that is less well known but clinically significant for its severe morbidity is hyperammonemic encephalopathy. We present a case of woman with hyperammonemic encephalopathy following the initiation of VPA therapy; she had a favourable outcome with discontinuation of the drug and prompt treatment with lactulose and L-carnitine.
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