Twilla Jennifer D, Pierce Andrew S
Methodist University Hospital, 1265 Union Avenue Memphis, TN 38104, USA ; Department of Clinical Pharmacy, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
Methodist University Hospital, 1265 Union Avenue Memphis, TN 38104, USA ; Department of Medicine, University of Tennessee Health Science Center, Memphis, TN 38163, USA.
Case Rep Psychiatry. 2014;2014:410403. doi: 10.1155/2014/410403. Epub 2014 Jul 17.
Valproic acid-induced hyperammonemic encephalopathy is a rare yet serious adverse drug reaction. Medication interactions such a valproic acid and topiramate can precipitate an event. We present the case of a 52-year-old female that presented with acute mental status change and hypersomnolence due to hyperammonemia caused by a valproic acid derivative. The patient improved after withdrawal of the offending medications and treatment with lactulose. Clinicians should remain hypervigilant in monitoring for valproic acid-induced hyperammonemic encephalopathy and risk factors such as polypharmacy.
丙戊酸诱导的高氨血症性脑病是一种罕见但严重的药物不良反应。丙戊酸与托吡酯等药物相互作用可引发该病症。我们报告了一例52岁女性病例,该患者因丙戊酸衍生物导致高氨血症,出现急性精神状态改变和嗜睡症状。停用致病药物并使用乳果糖治疗后,患者病情好转。临床医生应高度警惕监测丙戊酸诱导的高氨血症性脑病以及多药联用等危险因素。