Cerebellar atrophy in a child with valproate toxicity.

In the treatment of epilepsy, selecting an appropriate antiepileptic drug for each individual patient requires matching the patient's clinical needs with the agent's specific pharmacological attributes. In many situations, the final choice of an antiepileptic drug may need a change due to the agent's side-effect profile. The authors report a ten-year-old child with Lennox Gastaut syndrome who developed recurrence of seizures, hyperammonemic encephalopathy and cerebellar atrophy on valproate therapy. Valproate was discontinued and lamotrigine was added followed by good control of seizures. Cerebellar atrophy as a serious adverse side effect of valproate therapy, has been infrequently reported.