Valproic acid-induced encephalopathy: A review of clinical features, risk factors, diagnosis, and treatment

Epilepsy Behav. 2021 Jul:120:107967. doi: 10.1016/j.yebeh.2021.107967. Epub 2021 May 15.

Abstract

Valproic acid (VPA), or sodium valproate, is a commonly used medication for seizure disorders, migraines, and mental illness. Although VPA is relatively safe, it still has several adverse effects; among these, VPA-induced encephalopathy is the most serious. Valproic acid-induced encephalopathy mainly manifests as acute or subacute encephalopathy and has been associated with hyperammonemia, L-carnitine deficiency, and urea cycle enzyme dysfunction. Delayed identification of VPA-induced encephalopathy could be potentially fatal. Here, we perform an extensive review of relevant literature pertaining to VPA-induced encephalopathy, including its epidemiology, clinical features, possible pathophysiology, risk factors, diagnosis, and treatment.

Keywords: Encephalopathy; Hyperammonemia; L-carnitine; Urea cycle enzyme; Valproic acid.

Publication types

  • Research Support, Non-U.S. Gov't
  • Review

MeSH terms

  • Anticonvulsants / therapeutic use
  • Brain Diseases* / drug therapy
  • Humans
  • Hyperammonemia* / drug therapy
  • Risk Factors
  • Valproic Acid

Substances

  • Anticonvulsants
  • Valproic Acid