Serum and CSF glutamine levels in valproate-related hyperammonemic encephalopathy

Epilepsia
David G VosslerJohn D Morgan

Abstract

To investigate ammonia and glutamine levels in valproate (VPA)-related hyperammonemic encephalopathy (VHE). We reviewed the medical records and EEG recordings of seven adults diagnosed with VHE. Venous ammonia levels were elevated in five (71%) of the seven patients. Elevated serum or cerebrospinal fluid (CSF) glutamine levels were found in four (80%) of five cases tested, including two who had normal ammonia levels. Initial behavioral signs included violent outbursts in three patients, paranoid ideation severe enough to require restraint in two cases, and milder abnormalities in two instances. The severity of encephalopathy was not related to any particular serum VPA level. In four patients serum VPA levels did not exceed 100 microg/ml, and in one case, VHE developed after taking only one 250-mg dose. Symptoms eventually cleared after reducing the dose of, or discontinuing, VPA. Liver-function tests were normal. Each of six patients tested had EEG findings that supported the diagnosis of VHE and excluded nonconvulsive status epilepticus. The rate of normalization of one patient's serum glutamine level and the EEGs of two cases correlated better with the timing of their delayed clinical recovery than did the more rapid rate of ...Continue Reading

References

Sep 1, 1982·Archives of Neurology·J V Murphy, K Marquardt
May 1, 1993·The Annals of Pharmacotherapy·J DuarteL E Clavería
Feb 1, 1996·Neurology·A E Bryant, F E Dreifuss
May 1, 1997·Pediatric Neurology·B E GidalR S Rust
May 14, 1999·British Journal of Pharmacology·C M FraserM J Brodie
Jun 5, 1999·International Journal of Clinical & Laboratory Research·A VerrottiF Chiarelli
Jul 8, 2000·Kidney International
Jan 1, 1992·Drug and Alcohol Review·J E Maddison

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Citations

Oct 1, 2010·Neurotherapeutics : the Journal of the American Society for Experimental NeuroTherapeutics·Saul W BrusilowArthur J L Cooper
Oct 6, 2007·International Clinical Psychopharmacology·Marie-José C C Dealberto
May 28, 2008·Epilepsia·Ali A Asadi-PooyaMichael R Sperling
Aug 14, 2008·CNS Drugs·Gina M Kennedy, Samden D Lhatoo
Dec 10, 2013·Anales de pediatría : publicación oficial de la Asociación Española de Pediatría (A.E.P.)·B Fernández ColomerG D Coto Cotallo
Sep 3, 2009·Case Reports in Medicine·Vikrant MittalRajesh R Tampi
Nov 14, 2014·CNS Drugs·J van GaalenB P C van de Warrenburg
Sep 7, 2004·Journal of Clinical Psychopharmacology·Mariposa McCall, James A Bourgeois
Apr 7, 2007·Journal of Clinical Psychopharmacology·Joost NicolaiOebele F Brouwer
Dec 18, 2003·Journal of Toxicology. Clinical Toxicology·Alberto Perez, Charles A McKay
Dec 22, 2004·The Journal of Physiology·Lars NyboNiels H Secher
Jan 13, 2009·Pediatrics and Neonatology·Hsiao-Feng ChouYuh-Jyh Jong
Mar 21, 2009·Epilepsy Research·Jennifer L DeWolfeNita A Limdi
Jan 24, 2008·Psychosomatics·Aubrey L EubanksJames A Bourgeois
Nov 22, 2007·Annales Françaises D'anesthèsie Et De Rèanimation·P ParizeC Fischer
Apr 7, 2007·Epilepsy & Behavior : E&B·Y B GomceliL E Inan
Jun 16, 2006·Acta Neurologica Scandinavica·N Segura-BrunaJ Roquer
Jul 31, 2007·Acta Neurologica Scandinavica·S K Velioğlu, S Gazioğlu
Sep 24, 2004·Progress in Neuro-psychopharmacology & Biological Psychiatry·Andreas ReifAndreas J Fallgatter
Nov 29, 2015·Neurologic Clinics·Sai Krishna J Munjampalli, Debra E Davis
Oct 1, 2005·Pediatric Neurology·Mona Sazgar, Blaise F D Bourgeois
May 5, 2016·Case Reports in Critical Care·Gyanendra AcharyaHarmanjot Kaur
Jul 25, 2013·Innovations in Clinical Neuroscience·Vikas MangewalaMichele Knox
May 23, 2014·Journal of Child Neurology·Pankaj PrasunVinod K Misra
Sep 16, 2008·Renal Failure·Ming-Feng Tsai, Chen-Yin Chen
Aug 17, 2005·Arquivos de neuro-psiquiatria·Marlene de Fátima TurcatoCarolina Araújo Rodrigues Funayama
Feb 20, 2021·The Journal of Pediatric Pharmacology and Therapeutics : JPPT : the Official Journal of PPAG·Moftah AlhagamhmadAbdulhamid ElShiky
Sep 1, 2021·Journal of Clinical Pharmacy and Therapeutics·Ling ChenHao Huang

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