Hepatic encephalopathy precipitated by sodium valproate therapy

Subhash, H S; Heddle, Robert J; Schultz, David W; Ring, John; Thompson, Campbell H

doi:10.5694/j.1326-5377.2008.tb01780.x

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To the Editor: We report the case of a 71-year-old woman who presented with a 3-week history of lethargy, subacute confusion and drowsiness. She was known to have a seizure disorder for which she had been taking lamotrigine 100 mg and sodium valproate 500 mg twice a day for 2 years.

1 Division of Medicine, Flinders Medical Centre, Adelaide, SA.
2 Flinders University, Adelaide, SA.
3 Flinders Medical Centre and Flinders University, Adelaide, SA.

Correspondence: hssubhashcmc@hotmail.com

Acknowledgements:

We thank Professor Peter Roberts-Thomson, Director of the Department of Immunology at Flinders Medical Centre, for his expert opinion and advice.

1. DeVane CL. Pharmacokinetics, drug interactions, and tolerability of valproate. Psychopharmacol Bull 2003; 37 Suppl 2: 25-42.
2. Segura-Bruna N, Rodriguez-Campello A, Puente V, Roquer J. Valproate-induced hyperammonemic encephalopathy. Acta Neurol Scand 2006; 114: 1-7.
3. Gomceli YB, Kutlu G, Cavdar L, et al. Different clinical manifestations of hyperammonemic encephalopathy. Epilepsy Behav 2007; 10: 583-587.
4. Gerstner T, Buesing D, Longin E, et al. Valproic acid induced encephalopathy — 19 new cases in Germany from 1994 to 2003 — a side effect associated to VAP-therapy not only in young children. Seizure 2006; 15: 443-448.
5. Beyenburg S, Back C, Diederich N, et al. Is valproate encephalopathy under-recognised in older people? A case series. Age Ageing 2007; 36: 344-346.

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