title: Posterior reversible encephalopathy syndrome in a survivor of valproate-induced acute liver failure: a case report.
abstract: BACKGROUND
  Posterior reversible encephalopathy syndrome is an extremely rare radiological diagnosis that has not been reported previously in association with acute liver failure.
  
  
  METHODS
  A 6-year-old Sri Lankan girl developed acute liver failure with severe hepatic encephalopathy due to sodium valproate. She was successfully treated medically with N-acetylcysteine and L-carnitine. During recovery she again developed features of encephalopathy and had repeated convulsions associated with moderate hypertension. The diagnosis of posterior reversible encephalopathy syndrome was made on clinical and radiological grounds and she showed a gradual improvement with control of blood pressure.
  
  
  CONCLUSIONS
  This report adds to the evidence behind treatment of valproate-induced acute liver failure with N-acetylcysteine and L-carnitine and illustrates a rare but interesting association between acute liver failure and posterior reversible encephalopathy syndrome.
authors.affiliation: Department of Paediatrics, Faculty of Medicine, University of Kelaniya, P,O, Box 6, Ragama, Sri Lanka. sachithmetta@yahoo.com.
authors.forename: Sachith
authors.initials: S
authors.lastname: Mettananda
authors.forename: Asvini D
authors.initials: AD
authors.lastname: Fernando
authors.forename: Nimasari
authors.initials: N
authors.lastname: Ginige