title: Juvenile myoclonic epilepsy with multiple sclerosis: is there a dual role for valproate?
abstract: A 27-year-old woman was diagnosed with juvenile myoclonic epilepsy since the age of 13 and was on valproate therapy. She had a single episode of demyelinating illness while on valproate therapy. Two years earlier, her medication was changed to lamotrigine to avoid the teratogenic effects of valproate, after which the frequency of her demyelinating events increased to four episodes in 1.5 years, satisfying the revised McDonald criteria for multiple sclerosis. Valproate has been shown to restore T-cell homoestasis and ameliorate pathogenesis of experimental allergic encephalomyelitis, a mouse model of multiple sclerosis. Therefore, we propose a potential dual role of valproate in patients with co-existent juvenile myoclonic epilepsy and multiple sclerosis.
authors.affiliation: Department of Neurology, Sawai Mansingh Medical College and Hospital, Jaipur, Rajasthan, India.
authors.forename: Chandramohan
authors.initials: C
authors.lastname: Sharma
authors.affiliation: Department of Neurology, Sawai Mansingh Medical College and Hospital, Jaipur, Rajasthan, India.
authors.forename: Jigar
authors.initials: J
authors.lastname: Parekh
authors.affiliation: Department of Neurology, Sawai Mansingh Medical College and Hospital, Jaipur, Rajasthan, India.
authors.forename: Bansi Lal
authors.initials: BL
authors.lastname: Kumawat
authors.affiliation: Department of Neurology, Sawai Mansingh Medical College and Hospital, Jaipur, Rajasthan, India.
authors.forename: Mihir
authors.initials: M
authors.lastname: Acharya
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000627:therapeutic use; D001921:Brain / Q000473:pathology; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008279:Magnetic Resonance Imaging; D009103:Multiple Sclerosis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D020190:Myoclonic Epilepsy, Juvenile / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D014635:Valproic Acid / Q000627:therapeutic use*
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid
references.citation: Invest New Drugs. 2010 Dec;28 Suppl 1:S3-20
references.pmid: 21161327
references.citation: J Immunol. 2009 Dec 1;183(11):7169-77
references.pmid: 19890056
references.citation: Ann Neurol. 2011 Feb;69(2):292-302
references.pmid: 21387374
references.citation: J Biol Chem. 2012 Aug 17;287(34):28656-65
references.pmid: 22733814
references.citation: Neuroscience. 2012 Sep 27;221:140-50
references.pmid: 22800566
references.citation: Br J Pharmacol. 2011 Oct;164(4):1079-106
references.pmid: 21371012