title: Valproate induced hyperammonemic encephalopathy successfully treated with levocarnitine.
abstract: Valproate-induced hyperammonemic encephalopathy is an unusual but serious adverse effect that is usually characterized by the acute onset of impaired consciousness, focal neurological symptoms and increased seizure frequency. It has been reported to occur at therapeutic valproate levels. We report a patient who developed valproate-induced hyperammonemic encephalopathy after a short treatment with valproate and was successfully treated with levocarnitine. We discuss this patient and review the literature regarding the use of levocarnitine in similar patients.
authors.affiliation: Department of Neurology, Alessandro Manzoni Hospital, Via Dell'Eremo 9/11, 23900 Lecco, Italy. Electronic address: rig74@libero.it.
authors.forename: Andrea
authors.initials: A
authors.lastname: Rigamonti
authors.affiliation: Neuromuscular Diseases Unit, Carlo Besta Neurological Institute, IRCCS Foundation, Milan, Italy.
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Lauria
authors.affiliation: Department of Neurosurgery, Alessandro Manzoni Hospital, Lecco, Italy.
authors.forename: Gianluca
authors.initials: G
authors.lastname: Grimod
authors.affiliation: Department of Neurology, Alessandro Manzoni Hospital, Via Dell'Eremo 9/11, 23900 Lecco, Italy.
authors.forename: Graziella
authors.initials: G
authors.lastname: Bianchi
authors.affiliation: Department of Neurology, Alessandro Manzoni Hospital, Via Dell'Eremo 9/11, 23900 Lecco, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Salmaggi
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000009:adverse effects* / Q000627:therapeutic use; D001932:Brain Neoplasms / Q000188:drug therapy / Q000601:surgery; D003937:Diagnosis, Differential; D006801:Humans; D022124:Hyperammonemia / Q000139:chemically induced*; D008297:Male; D020258:Neurotoxicity Syndromes / Q000175:diagnosis; D012640:Seizures / Q000139:chemically induced / Q000175:diagnosis / Q000188:drug therapy; D014635:Valproic Acid / Q000009:adverse effects* / Q000627:therapeutic use
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid
keywords: Encephalopathy; Hyperammonemia; Levocarnitine; Valproic acid