Encefalopatía asociada a Valproato

• Pablo Young ^[1] ; Bárbara C Finn ^[1] ; Florencia Álvarez ^[1] ; Julio E Bruetman ^[1] ; Hernán Trimarchi ^[1]
  1. [1] Hospital Británico de Buenos Aires

     Hospital Británico de Buenos Aires

     Argentina

     
• Localización: Revista Médica de Chile, ISSN-e 0034-9887, Vol. 135, Nº. 11, 2007, págs. 1446-1449
• Idioma: español
• Títulos paralelos:
  • Val proate-associated hyperammonemic encephalopathy. Report of one case
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• Resumen

  • Valproate can be associated to hyperammonemic encephalopathy, characterized by fluctuating sudden-onset alterations of sensorium, focal symptoms and an increase in the frequency of seizures. We report a 78 year-old female using valproate 1,000 mg/ day for 10 months for the treatment to tonic-clonic seizures. She was admitted on three occasions in the last fourth months for self limited clouding of sensorium. Laboratory, imaging and electroencephalografic studies were non-contributory Blood ammonia levels were 123 fig/dl (normal: 15-50 fig/dl). Due to the possibility of a hyperammonemic encephalopathy secondary to valproate, the drug was discontinued and she was treated with lactulose and intravenous L-carnitine, 1 g/day The patient showed a complete recovery within 48 hours. This drug-associated encephalopathy is a reversible but potentially fatal cause, probably underdiagnosed, that requires a high index of suspicion