Hyperammonemia and hepatic status during valproate therapy

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Valproate-induced hyperammonemia in juvenile ceroid lipofuscinosis (Batten disease)

PURPOSE Valproate-induced hyperammonemia (VHA) and hyperammonemic encephalopathy (VHE) are well-known complications of valproate (VPA) treatment. Currently recognised risk factors for VHE include a high VPA dosage, the need for polytherapy and long duration of treatment. Despite the severe nature of the epilepsy, presence of concomitant psychiatric manifestations, and frequent need for poly-pha...

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Adding topiramate to valproate therapy may cause reversible hepatic failure.

The authors report a 51-year-old women with pharmacoresistant partial epilepsy who tolerated well valproate monotherapy and in combination with several other antiepileptic drugs, but developed symptoms and signs of reversible hepatic failure under a combination of valproate and topiramate. Symptoms resolved after discontinuation of VPA. This case provides further anecdotal evidence that topiram...

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Therapy of hyperammonemia

Recently, Ghallab and colleagues have identified a novel strategy to reduce hyper-ammonemia in mice (Ghallab et al., 2015). The authors reduced blood ammonia concentrations by infusing a cocktail of glutamate dehydrogenase and its cofactors alpha-ketoglutarate and NADPH. This approach may be clinically relevant, because therapy of hyperammonemia is challenging (Levesque et al., 1999; Enns et al...

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Reversible dementia and apparent brain atrophy during valproate therapy.

Two children developed severe cognitive and behavioral deterioration suggestive of a degenerative disease while being treated with sodium valproate for idiopathic, localization-related epilepsy with centrotemporal spikes. Magnetic resonance imaging revealed marked central and generalized cortical and cerebellar atrophy. In both patients, clinical symptoms and signs cleared in a few weeks follow...

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Hyperammonemia is a recognized cause of encephalopathy. However, it is commonly seen in patients with liver disease. The clinical entity of noncirrhotic hyperammonemia is now being increasingly recognized. We report a man who presented to our hospital with relapsing altered mental status later diagnosed as noncirrhotic hyperammonemia.

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ژورنال

عنوان ژورنال: Indian Journal of Clinical Biochemistry

سال: 2009

ISSN: 0970-1915,0974-0422

DOI: 10.1007/s12291-009-0066-2