title: Valproate therapy exacerbating intermediate phenotype of methylmalonic aciduria.
abstract: A, 11-year-old male, with delayed milestones after the age of 6 months with recurrent myoclonus and generalized tonic-clonic seizures had clinical worsening after institution of valproate, was detected to have elevated serum lactate level and marked methyl malonic aciduria. Patient had remarkable improvement following withdrawal of valproate and substitution of hydroxocobalamin.
authors.affiliation: Department of Neurology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.
authors.forename: Aditya
authors.initials: A
authors.lastname: Murgai
authors.affiliation: Department of Neurology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.
authors.forename: Aviraj
authors.initials: A
authors.lastname: Deshmukh
authors.affiliation: Department of Neurology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.
authors.forename: Vinod
authors.initials: V
authors.lastname: Puri
authors.affiliation: Department of Neurology, GB Pant Institute of Post Graduate Medical Education and Research, New Delhi, India.
authors.forename: Neera
authors.initials: N
authors.lastname: Chaudhry
authors.affiliation: Department of Pediatrics, Genetic Unit, MAMC, New Delhi, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Kapoor
keywords: Anti-epileptic drug; Vitamin B12 deficiency; methylmalonic aciduria; multi focal spikes in electroencephalogram; organic aciduria; valproic acid