Tratamiento de la encefalopatía por ácido valproico con ácido carbaglúmico: descripción de dos casos y revisión de la bibliografía

Nava-Mateos, J J; Roiz-Rey, P; Alvarez-Mediavilla, J Diaz; Cebrian-Novella, D; Olmo, V Gomez-Del; Ceberio-Hualde, Leticia

doi:10.33588/rn.6509.2017226

Cited by 2 publications

(1 citation statement)

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“…It is a structural analog of Nacetylglutamate (NAG) that activates carbamoyl phosphate synthetase 1 (CPS1) in the urea cycle (Figure 3). It has traditionally been used in pediatric patients for the treatment of hyperammonemic encephalopathy due to valproate toxicity [19]. However, the efficacy of carglumic acid for valproate toxicity is unclear, especially in adults, and there have not been any randomized controlled trials using carglumic acid for valproate toxicity [19].…”

Section: Current Literature On Treating Valproate Toxicitymentioning

confidence: 99%

Valproate-Induced Encephalopathy Presenting at Therapeutic Blood Concentrations: A Case Report and Literature Review

Pavar¹,

Xu²,

Sawar³

et al. 2023

Cureus

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Patients presenting with hyperammonemic encephalopathy are likely to have hepatic encephalopathy. However, valproate (an anticonvulsant and mood stabilizer) can also cause hyperammonemic encephalopathy and belongs on the differential for patients taking it, especially if there are recent contributory medication changes. We present a case report of a 61-year-old woman with valproate-induced hyperammonemic encephalopathy but with an initial valproate level within the therapeutic range (50-100 mcg/dL). After withholding valproate and before additional treatment could be initiated, she became fully alert and oriented. We present a literature review exploring valproate toxicity and treatment. Our case shows that clinical suspicion for valproate-induced hyperammonemic encephalopathy is warranted even if the valproate level is within the therapeutic range.

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Section: Current Literature On Treating Valproate Toxicitymentioning

confidence: 99%