Reversible cortical atrophy and cognitive decline induced by valproic acid.
An 18-year-old male suffered from familial progressive myoclonic epilepsy from the age of 7 years. In addition to seizures, there was a marked decline in school performance. At the age of 14 years, sodium valproate was started as add-on therapy; 2 weeks later he was hospitalized in a stuporous state. The serum level of valproate was within the therapeutic range. Cognitive evaluation disclosed moderate mental retardation. No metabolic abnormalities were detected. Valproate was discontinued and during the 4 following months, a slow but significant improvement was documented in cognitive functions. Repeated assessment was within the range of mild mental retardation. Initially, magnetic resonance imaging (MRI) showed mild cortical atrophy. A subsequent MRI study performed 2 years later was normal.
Straussberg
R
R
Department of Child Neurology, Schneider Children's Medical Center, Petah Tiqva, Israel.
Kivity
S
S
Weitz
R
R
Harel
L
L
Gadoth
N
N
D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects*; D001284:Atrophy / Q000139:chemically induced / Q000473:pathology; D002540:Cerebral Cortex / Q000473:pathology*; D003072:Cognition Disorders / Q000139:chemically induced* / Q000175:diagnosis; D004569:Electroencephalography; D004831:Epilepsies, Myoclonic / Q000175:diagnosis / Q000188:drug therapy; D006801:Humans; D008279:Magnetic Resonance Imaging; D008297:Male; D020127:Recovery of Function; D012720:Severity of Illness Index; D014635:Valproic Acid / Q000009:adverse effects*
D000927:Anticonvulsants; D014635:Valproic Acid