title: [Acute valproic acid intoxication: interest of a treatment by extracoporeal elimination combined with L-carnitine].
abstract: We present the case of a 24-year-old-female patient, who made an attempt to autolysis with valproic acid, benzodiazepines and neuroleptic. The valproic acid plasma level was very high (1437 μg/mL), confirming it was a severe intoxication. She presents an acute encephalopathy with prolonged status epilepticus, a lactic metabolic acidosis and hematologic disorders such as bicytopenia. Treatment including L-carnintine and continuous veno-venous haemodialysis (CVVHD) was rapidly introduced to prevent the occurrence of cerebral oedema. The evolution was favourable despite the occurrence of a nosocomial ventilation acute lung injury. The patient had motor sequelae of cranial nerves following status epilepticus extended, which disappeared spontaneously after several days.
authors.affiliation: Service de Réanimation Polyvalente, Centre Hospitalier D'armentières, 112, rue Sadi-Carnot, BP 189, 59421 Armentières Cedex, France. a_alluin@hotmail.com
authors.forename: A
authors.initials: A
authors.lastname: Alluin
authors.forename: J
authors.initials: J
authors.lastname: Jezequel
authors.forename: N
authors.initials: N
authors.lastname: Gauthier
authors.forename: J-L
authors.initials: JL
authors.lastname: Desmaretz
authors.forename: C
authors.initials: C
authors.lastname: Canevet
mesh_terms: D000140:Acidosis, Lactic / Q000139:chemically induced / Q000628:therapy; D055371:Acute Lung Injury / Q000209:etiology; D000927:Anticonvulsants / Q000097:blood / Q000506:poisoning*; D002331:Carnitine / Q000627:therapeutic use*; D003389:Cranial Nerve Diseases / Q000139:chemically induced; D004569:Electroencephalography; D005260:Female; D006440:Hemofiltration / Q000379:methods*; D006801:Humans; D012121:Respiration, Artificial / Q000009:adverse effects; D013226:Status Epilepticus / Q000139:chemically induced / Q000628:therapy; D013406:Suicide, Attempted; D013921:Thrombocytopenia / Q000209:etiology / Q000628:therapy; D014635:Valproic Acid / Q000097:blood / Q000506:poisoning*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid; D002331:Carnitine