A Rare and Reversible Cause of Encephalopathy: Valproic Acid Encephalopathy Ensefalopatinin Nadir ve Geri Dönüşümlü Bir Nedeni: Valproik Asit Ensefalopatisi
Journal of Uludag University Medical Faculty, cilt.52, 2026 (Scopus)
- Yayın Türü: Makale / Tam Makale
- Cilt numarası: 52
- Basım Tarihi: 2026
- Doi Numarası: 10.32708/uutfd.1930595
- Dergi Adı: Journal of Uludag University Medical Faculty
- Derginin Tarandığı İndeksler: Scopus
- Anahtar Kelimeler: Encephalopathy, Hyperammonemic, Non-hepatic, Side effect, Valproic acid
- Açık Arşiv Koleksiyonu: AVESİS Açık Erişim Koleksiyonu
- Bursa Uludağ Üniversitesi Adresli: Evet
Özet
Valproic acid encephalopathy is a rare etiology of encephalopathy, characterized by altered consciousness, cognitive slowing, focal neurological deficits, and paradoxical seizure increase in epileptic patients, all developing during valproic acid treatment. It may be hyperammonemia-related (most common), non-hyperammonemia-related, or hepatotoxicity-related. Serum valproate levels may be elevated or within the therapeutic range. EEG showing diffuse slowing of background activity and triphasic waves is helpful. Our case involves a patient with schizophrenia who was using valproate and developed seizure increase and encephalopathy without obvious metabolic or hepatic predisposing factors. Serum valproic acid levels were within the therapeutic range, but EEG revealed severe encephalopathy with diffuse slowing of background activity, and elevated serum ammonia levels led to diagnosis. Symptoms resolved with discontinuation of valproate and L-carnitine treatment. In the psychiatric patient group, differentiating the findings from encephalopathy and the fact that they are reversible with early diagnosis and treatment are critical.