Ammonia: what adult neurologists need to know

Pract Neurol. 2020 Dec 11:practneurol-2020-002654. doi: 10.1136/practneurol-2020-002654. Online ahead of print.

Abstract

Hyperammonaemia is often encountered in acute neurology and can be the cause of acute or chronic neurological symptoms. Patients with hyperammonaemia may present with seizures or encephalopathy, or may be entirely asymptomatic. The underlying causes are diverse but often straightforward to diagnose, although sometimes require specialist investigations. Haemodialysis or haemo(dia)filtration is the first-line treatment for acute severe hyperammonaemia (of any cause) in an adult. Here we discuss our approach to adult patients with hyperammonaemia identified by a neurologist.

Keywords: Coma; epilepsy; metabolic disease.