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VOLUME 18 , ISSUE 7 ( July, 2014 ) > List of Articles

CASE REPORT

Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis

Amandeep Kumar, Ashish Suri, Bhawani S. Sharma

Keywords : Dialysis, valproate induce hyperammonemia, valproate induced hyperammonemic encephalopathy, valproic acid

Citation Information : Kumar A, Suri A, Sharma BS. Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis. Indian J Crit Care Med 2014; 18 (7):461-463.

DOI: 10.4103/0972-5229.136076

License: CC BY-ND 3.0

Published Online: 01-07-2014

Copyright Statement:  Copyright © 2014; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Valproic acid (VPA) is a commonly used drug for epilepsy, psychiatric disorders and migraine and is frequently used in neurosurgical intensive care units. Though most of its side-effects are mild and transient, certain idiosyncratic side-effects have been attributed to VPA. Valproate induced hyperammonemia (VIH) is one such side-effect. VIH can produce symptoms of encephalopathy known as valproate induced hyperammonemic encephalopathy (VHE). VIH and VHE usually respond to withdrawal of VPA. However, in some cases VHE can be unresponsive to supportive measures and severe enough to be life-threatening. In such cases, dialysis can be used to rapidly reverse hyperammonemia and VHE and can prove to be a lifesaving measure. We report such a case of VIH and life-threatening VHE in a postoperative neurosurgical patient that was managed successfully with peritoneal dialysis.


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