Clinical characteristics of valproate-induced encephalopathy: analyses of 10 cases
10.3760/cma.j.issn.0254-9026.2013.01.009
- VernacularTitle:老年人丙戊酸钠脑病10例并文献复习
- Author:
Xiaoling ZHANG
;
Qiaobing GUAN
;
Shuxia QIAN
- Publication Type:Journal Article
- Keywords:
Valproic acid;
Brain diseases
- From:
Chinese Journal of Geriatrics
2013;(1):33-36
- CountryChina
- Language:Chinese
-
Abstract:
Objective To analysis the clinical features of valproate (VPA)-induced encephalopathy in elderly people in order to improve our cognition toward it.Methods From March 2003 to March 2011,a total of 10 cases with VPA-induced encephalopathy were retrospectively reviewed and summarized.The data collected included clinical manifestations,biochemistry,EEG and therapeutic effects.Results In the 10 cases,8 were males and 2 females.The age ranged from 65-88 years old (mean age 75.4±10.3 years).7 subjects were on treatment with VPA alone,and the other 3 in combination with other anti-epileptic drugs.The serum VPA level in this study ranged from 62.1-122.7 μg/ml with mean of (92.3 ± 30.1) mg/L (normal range 50-100 mg/L).All subjects presented with confusion and cognitive impairment.The serum ammonia level in this study ranged from 56.7-225.1 μmol/L with mean of (101.4±55.2) μmol/L (normal range 11-32 μmol/L).All cases were with normal liver function.Electroencephalography was characterized by signs of severe encephalopathy with continuous generalized slowing,a predominance of θ and δ activity,occasional bursts of epileptiform discharges and triphasic waves.All cases were improved 3-21 days after VPA withdrawal.Conclusions VPA-induced encephalopathy that manifested in confusion and cognitive impairment is not uncommon in elderly patients and it has a good prognosis and the early withdrawal of VPA lads to improvement in almost all cases.
