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[Acute valproic acid intoxication: interest of a treatment by extracoporeal elimination combined with L-carnitine].

作者信息

Alluin A, Jezequel J, Gauthier N, Desmaretz J-L, Canevet C

机构信息

Service de Réanimation Polyvalente, Centre Hospitalier D'armentières, 112, rue Sadi-Carnot, BP 189, 59421 Armentières Cedex, France.

出版信息

Ann Fr Anesth Reanim. 2011 Oct;30(10):752-4. doi: 10.1016/j.annfar.2011.05.019. Epub 2011 Jul 22.

Abstract

We present the case of a 24-year-old-female patient, who made an attempt to autolysis with valproic acid, benzodiazepines and neuroleptic. The valproic acid plasma level was very high (1437 μg/mL), confirming it was a severe intoxication. She presents an acute encephalopathy with prolonged status epilepticus, a lactic metabolic acidosis and hematologic disorders such as bicytopenia. Treatment including L-carnintine and continuous veno-venous haemodialysis (CVVHD) was rapidly introduced to prevent the occurrence of cerebral oedema. The evolution was favourable despite the occurrence of a nosocomial ventilation acute lung injury. The patient had motor sequelae of cranial nerves following status epilepticus extended, which disappeared spontaneously after several days.

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