title: The frequency of reversible parkinsonism and cognitive decline associated with valproate treatment: a study of 364 patients with different types of epilepsy.
abstract: OBJECTIVE
  We report the frequency of parkinsonism and cognitive decline (P/CD) in patients treated with valproate (VPA) after 1 year of treatment and at least 1 year of follow-up.
  
  
  METHODS
  Three hundred sixty-four patients with various epileptic syndromes and seizure types were treated with VPA mono- or polytherapy for more than 1 year.
  
  
  RESULTS
  We found five cases of P/CD (1.37%; 95% CI, 0.18-2.56%). Among 140 patients with different adverse effects (AEs) of VPA, P/CD were among the rarest in frequency but significant in terms of drug discontinuation (five of 17).
  
  
  CONCLUSIONS
  Early identification of this type of AE and discontinuation of the drug led to complete recovery in affected patients.
authors.affiliation: Institute of Neurology, Clinical Center of Serbia, Belgrade, Serbia.
authors.forename: Aleksandar J
authors.initials: AJ
authors.lastname: Ristić
authors.forename: Nikola
authors.initials: N
authors.lastname: Vojvodić
authors.forename: Slavko
authors.initials: S
authors.lastname: Janković
authors.forename: Aleksandra
authors.initials: A
authors.lastname: Sindelić
authors.forename: Dragoslav
authors.initials: D
authors.lastname: Sokić
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D003072:Cognition Disorders / Q000139:chemically induced* / Q000453:epidemiology; D004334:Drug Administration Schedule; D004359:Drug Therapy, Combination; D004827:Epilepsy / Q000145:classification / Q000175:diagnosis / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008137:Longitudinal Studies; D008297:Male; D008875:Middle Aged; D010302:Parkinson Disease, Secondary / Q000139:chemically induced* / Q000453:epidemiology; D015995:Prevalence; D012720:Severity of Illness Index; D016896:Treatment Outcome; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid