Korean J Med.
2008 Dec;75(6):680-684.
A case of valproic acid-induced hyperammonemic encephalopathy with normal liver function
- Affiliations
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- 1Department of Internal Medicine, College of Medicine Chung-Ang University, Seoul, Korea. ekg001@chol.com
- 2Department of Neurosurgery, College of Medicine Chung-Ang University, Seoul, Korea.
Abstract
- Valproic acid is an effective anticonvulsant used in neurology and psychiatry. Valproic acid-induced hyperammonemic encephalopathy is an unusual complication characterized by a decreasing level of consciousness, the development of progressive confusional states and, sometimes, a coexisting increase in the frequency of seizures after the onset of valproic acid treatment. It can lead to death, but can be reversed if a swift diagnosis is made. We report the case of a 58-year-old woman with an intracerebral hemorrhage and normal liver function who presented with valproic acid-induced hyperammonemic encephalopathy. After valproic acid treatment, she developed encephalopathy and became comatose, with seizures and a markedly elevated serum ammonia level. Her neurologic manifestations and hyperammonemia improved after discontinuing the valproic acid.
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