title: Neonatal episodic hypoglycemia: a finding of valproic acid withdrawal.
abstract: The treatment of epilepsy during pregnancy is a worldwide problem. Drugs need to be used to control seizures in the mothers. In utero, exposure to valproic acid (VPA) and phenytoin (PH) may cause congenital malformations and also withdrawal symptoms such as irritability, jitteriness and symptoms of hypoglycemia. We present here a newborn with episodic hypoglycemia due to in utero exposure to VPA and PH. The mother was diagnosed as having complex partial epilepsy and was treated with PH (200 mg/day) and VPA (600 mg/day). The offspring developed jitteriness on the second day of life. The infant was hypoglycemic (32 mg/dl). These findings were accepted as withdrawal symptoms, since serum levels of VPA and PH were 37.8 μg/ml (50-100 μg/ml) and 6.37 μg/dl (10-20 μg/ml), respectively. Measurement of blood glucose is important and should be carefully monitored in infants exposed to antiepileptics in utero.
authors.affiliation: Erciyes University Faculty of Medicine, Department of Pediatrics, Division of Neonatology, 38039 Kayseri, Turkey. drdilekcoban@yahoo.com.tr
authors.forename: Dilek
authors.initials: D
authors.lastname: Çoban
authors.forename: Selim
authors.initials: S
authors.lastname: Kurtoğlu
authors.forename: Mustafa Ali
authors.initials: MA
authors.lastname: Akın
authors.forename: Mustafa
authors.initials: M
authors.lastname: Akçakuş
authors.forename: Tamer
authors.initials: T
authors.lastname: Güneş
mesh_terms: D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D004827:Epilepsy / Q000188:drug therapy; D005260:Female; D005947:Glucose / Q000008:administration & dosage / Q000627:therapeutic use; D006801:Humans; D007003:Hypoglycemia / Q000139:chemically induced* / Q000188:drug therapy; D007231:Infant, Newborn; D007232:Infant, Newborn, Diseases / Q000139:chemically induced* / Q000188:drug therapy; D007262:Infusions, Intravenous; D008297:Male; D011247:Pregnancy; D011248:Pregnancy Complications / Q000188:drug therapy; D011297:Prenatal Exposure Delayed Effects / Q000139:chemically induced* / Q000188:drug therapy; D016896:Treatment Outcome; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid; D005947:Glucose