Valproate-induced hyperammonemic encephalopathy: a brief review

Abstract

Background:

This brief review presents a comprehensive evaluation of valproate-induced encephalopathy (VHE) and also discusses potential mechanisms of the condition.

Scope:

Sodium valproate (VPA) is an effective antiepileptic drug used in neurology as well as in psychiatry, in adults and children. VHE requires early diagnosis and management. Focused research efforts in understanding the condition will help decrease its incidence. Delay in recognition of VHE can result in the development of potentially life-threatening complications.

Findings:

Management options are described. Since VPA frequently causes a modest rise in plasma ammonia levels which is asymptomatic, it is important to recognize the symptoms of VHE promptly and to correlate them with the plasma ammonia levels.

Conclusions:

Although there are several case reports on VHE, this review is a comprehensive evaluation of its causes and potential mechanisms. Rapid diagnosis and management will help in reducing VHE-related morbidity.

Keywords::

• Carnitine
• Depakote
• Encephalopathy
• Hyperammonemia

Transparency

Declaration of funding

This study was not funded.

Declaration of financial/other relationships

C.L., A.D., G.T. and R.D. have no relevant financial relationships to declare.

CMRO peer reviewers on this manuscript have no relevant financial relationships to declare. No medical writers were involved in the writing of this manuscript.