Valproate-induced hyperammonemic encephalopathy:case report and literatures review
DENG Qi-pan
SONG Jian
YAO Guo-jie
XU Guo-zhen
MA Lian-ting
Abstract：Objective To discuss the value of monitoring serum concentrations of sodium valproate (SVP) to prevention and diagnosis of valproate-induced hyperammonemic encephalopathy (VIHAE) in the patient in whom SVP was used in order to prevent epilepsy after craniotomy. Methods The clinical data of a patient with VIHAE, who received intravenous infusion of SVP in order to prevent epilepsy after the removal of left temporal tumor, were analyzed retrospectively, including the clinical symptoms and signs, and data of laboratory examination and neurological imaging. The causes of disturbance of consciousness were analyzed. Results A 31 year old underweight woman with left temporal tumor was intravenously infused by SVP in order to prevent postoperative epilepsy immediately after the resection of the tumors. The mental symptoms, disturbance of consciousness, paroxysmal twitch, and hemiplegic paralysis gradually appeared 3 days after the surgery in the patient. The brainstern lessions and large area brain infarction or intracranial diffuse hemorrhage were not found by CT and MR reexaminations. The biochemical examination showed that blood ammonia and the serum concentration of SVP were moderately elevated, therefore VIHAE was definitely diagnosed as. The use of SVP was stopped immediately after the diagnosis was definitely made and then the above-mentioned symptoms gradually disappeared. Conclusion Monitoring the level of ammonia and serum concentrations of SVP should be recommended in the patients to whom SVP is administered for prevention of epilepsy after the craniotomy.
Keywords：Hyperammonemic encephalopathySodium valproateBlood ammoniaPostoperative epilepsy
Publication Date：2016-01-01
Online Publishing Date：2025-08-15(First online date of this platform, not the publication date of the document)
Pages：4( 30-33 )