Gingival hyperplasia due to sodium valproate.

Abstract

A complete necropsy showed multiple acute liver necroses, fibrinous endocarditis, subpleural petechiae, pulmonary oedema and the morphological signs of shock. The neuropathological investigation revealed a typical epidermoid cyst at the base of the brain extending from the interpenduncular fossa to the upper medulla oblongata with a mean diameter of 1 cm. The whole left aspect ofthe pons and the left cerebellopontine angle were covered by the tumour. Both oculomotor nerves, the left trigeminal, facial and the vestibulocochlear nerves as well as both abducent and glossopharyngeal nerves were covered with pearly masses. The tumour lacked calcifications. There was no bone destruction at the base of the skull. The brainstem was slightly displaced to the right.We conclude that in cases with cranial nerve lesions and cerebellar signs or even meningeal signs an epidermoid cyst at the base of the brain should be excluded. As our observations show, routine performance of CT and MRI may fail to reveal the tumour.

Drug-induced gingival overgrowth: A critical insight into case reports from over two decades

“…Nevertheless, the clinical and histological picture of gingival enlargement and the medical history of the patient led some investigators to diagnose the enlargement as a combination of inflammatory and DIGO. [4] Addition of inflammatory component to the gingival overgrowth, thus complicates the diagnosis and also the management of DIGO.…”

“…[3] In addition, drugs such as sodium valproate[4] and erythromycin[5] induced gingival enlargements have also been reported in the past. Although the chemical nature of the three drug groups is different, they have a similar mechanism of action at the cellular level, where they inhibit intracellular calcium ion influx.…”

A review and guide to drug‐associated oral adverse effects—Dental, salivary and neurosensory reactions. Part 1

“…Prevalence has been reported between 13% and 50%, with a retrospective analysis of ADR databases finding that DGE was observed around 1‐3 months after starting phenytoin . Case reports of other anticonvulsants associated with DGE include valproate, vigabatrin and phenobarbitone, but these reports are rare or less well documented (Tables ).…”

Congenital Gingival Hyperplasia in a Neonate with Foetal Valproate Syndrome

“…Other side effects include nausea, vomiting, indigestion, transient hair loss, thrombocytopaenia and hyperammonaemia. Infantile gingival overgrowth secondary to sodium valproate use is uncommon and it has only been reported in 4 isolated cases, of which only one was congenital [1,3,11,12] . The teratogenicity of sodium valproate was fi rst demonstrated in 1982 by Dalens et al [5] .…”