Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis

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 hyperam...

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Main Authors:	Kumar, Amandeep, Suri, Ashish, Sharma, Bhawani S.
Format:	Online
Language:	English
Published:	Medknow Publications & Media Pvt Ltd 2014
Online Access:	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4118513/

id	pubmed-4118513
recordtype	oai_dc
spelling	pubmed-41185132014-08-05 Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis Kumar, Amandeep Suri, Ashish Sharma, Bhawani S. Case Report 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. Medknow Publications & Media Pvt Ltd 2014-07 /pmc/articles/PMC4118513/ /pubmed/25097360 http://dx.doi.org/10.4103/0972-5229.136076 Text en Copyright: © Indian Journal of Critical Care Medicine http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
repository_type	Open Access Journal
institution_category	Foreign Institution
institution	US National Center for Biotechnology Information
building	NCBI PubMed
collection	Online Access
language	English
format	Online
author	Kumar, Amandeep Suri, Ashish Sharma, Bhawani S.
spellingShingle	Kumar, Amandeep Suri, Ashish Sharma, Bhawani S. Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis
author_facet	Kumar, Amandeep Suri, Ashish Sharma, Bhawani S.
author_sort	Kumar, Amandeep
title	Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis
title_short	Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis
title_full	Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis
title_fullStr	Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis
title_full_unstemmed	Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis
title_sort	severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis
description	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.
publisher	Medknow Publications & Media Pvt Ltd
publishDate	2014
url	https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4118513/
_version_	1613119905692909568

Severe valproate induced hyperammonemic encephalopathy successfully managed with peritoneal dialysis

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