瓦尔酸诱导非超血性脑病变低于标准血清度范围:一个病例报告
Tomohiro Uemura1, Nana Suzuki1, Jun Souma1
1Division of Respiratory Medicine and Neurology, Department of Internal Medicine, Asahikawa Medical University, Asahikawa, Hokkaido, Japan.
Medicine
|July 15, 2025
概括
瓦尔酸盐 (VPA) 诱导的脑病变可以发生在没有高氨或低卡尼丁水平的情况下. 停止使用VPA迅速改善了患者的神经症状,强调立即停止的重要性.
科学领域:
- 神经学 神经学
- 药理学 药理学是指药理学的学科.
- 毒理学 毒理学 毒理学
背景情况:
- 酸 (VPA) 用于治疗情绪障碍,但可能导致脑病变.
- 由VPA引起的脑病变通常表现为意识改变,或精神问题.
- 它通常与高氨血症或低L-卡尼丁一起发生,但可以在没有这些标志物的情况下出现.
研究的目的:
- 描述一种由VPA引起的非高血性脑病变的病例.
- 强调考虑VPA诱导脑病变的重要性,即使氨和肉的水平正常.
主要方法:
- 一名71岁的男性接受了长期的VPA治疗,出现了持续的意识障碍.
- 实验室测试显示氨和肉是正常的,但VPA水平低于治疗水平.
- 脑成像和脑电图显示出与脑病变相一致的异常.
主要成果:
- 这名患者被诊断为VPA诱导的非高血性脑病变.
- 停止VPA导致意识的逐渐恢复和EEG的改善.
- 患者在出院后完全康复,没有进一步的神经或认知障碍.
结论:
- 在VPA治疗期间出现神经症状的患者中,应该怀疑VPA诱导的脑病变,无论氨或肉的水平如何.
- 即使VPA水平低于治疗水平,也不能排除VPA引起的脑病变.
- 立即停止VPA对于症状的解决至关重要.
相关概念视频
Antiepileptic Drugs: GABAergic Pathway Potentiators
660
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...
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
660
Nonlinear Pharmacokinetics: Dependence of Elimination Half-Life and Dose Clearance
302
The elimination half-life and drug clearance of drugs following nonlinear kinetics can vary with dosage. The Michaelis-Menten parameters and drug concentration influence these factors. As the dose increases, the elimination half-life tends to lengthen, resulting in a reduction in clearance and a disproportionately larger area under the curve. The total clearance can be derived from the Michaelis-Menten equation for drugs following a one-compartment model.
A study on guinea pigs examined the...
A study on guinea pigs examined the...
302
Antiepileptic Drugs: Modulators of Neurotransmitter Release Mediated by SV2A Protein
455
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...
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...
455
Antiepileptic Drugs: Glutamate Antagonists
521
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...
521
Antiepileptic Drugs: Potassium Channel Activators
282
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...
Ezogabine has gained approval as an adjunctive treatment...
282
Nonlinear Pharmacokinetics: Bioavailability and Protein-Drug Binding
279
When a drug follows nonlinear pharmacokinetics, its bioavailability, the amount of the drug that reaches the systemic circulation, can change with different doses. This is due to the presence of a saturable pathway. The pathway becomes saturated as the drug concentration increases, decreasing the absorption rate. Consequently, the drug's bioavailability may be lower than expected at higher doses.
To quantify the extent of bioavailability, pharmacologists often use a parameter called .
To quantify the extent of bioavailability, pharmacologists often use a parameter called .
279


