Zhang Xiaorong, Lu Wei, Mo Xiaoye
Department of Neuroendocrinology, The First Veterans Hospital of Sichuan Province, Sichuan Province Revolutionary Disable Armyman Rehab, Chengdu, China.
Department of Neurology, Second Xiangya Hospital, Central South University, Changsha, China.
Front Neurol. 2023 Mar 14;14:1104251. doi: 10.3389/fneur.2023.1104251. eCollection 2023.
Enuresis is an uncommon adverse effect of sodium valproate therapy that is unknown to most clinicians. This study provides an overview of the literature on enuresis associated with sodium valproate therapy, discussing the clinical manifestations and possible mechanisms of this side effect.
We reported three cases of enuresis induced by sodium valproate and reviewed the published enuresis cases associated with sodium valproate therapy retrieved from databases.
Three new patients with epilepsy who presented with enuresis following sodium valproate therapy were reported, and 55 published cases of nocturnal enuresis associated with sodium valproate were evaluated. The average age of these patients varied from 4 to 20 years. A total of 48 cases had generalized seizures, seven had focal seizures, and three had unknown seizures. In all the patients, the plasma concentration of sodium valproate was 80.76 ± 14.80 μg/mL, within the therapeutic range when enuresis occurred. With discontinuation or reduction of the drug, all the patients recovered completely.
Sodium valproate-induced enuresis is a rare and reversible side effect, occurring at a younger age, characterized by the generalized onset of seizures, and a rather high dose. The possible mechanisms include insufficient secretion of anti-diuretic hormones, sleep disorder, and hyperactivity of the parasympathetic system. Clinicians should be aware of this uncommon side effect to avoid an incorrect adjustment of the treatment direction.
遗尿症是丙戊酸钠治疗中一种不常见的不良反应，大多数临床医生对此并不了解。本研究综述了与丙戊酸钠治疗相关的遗尿症文献，探讨了这种副作用的临床表现和可能机制。
我们报告了3例由丙戊酸钠诱发的遗尿症病例，并回顾了从数据库中检索到的已发表的与丙戊酸钠治疗相关的遗尿症病例。
报告了3例新的癫痫患者，他们在接受丙戊酸钠治疗后出现遗尿症，并对55例已发表的与丙戊酸钠相关的夜间遗尿症病例进行了评估。这些患者的平均年龄在4至20岁之间。共有48例为全身性癫痫发作，7例为局灶性癫痫发作，3例癫痫发作类型不明。在所有患者中，丙戊酸钠的血浆浓度为80.76±14.80μg/mL，在出现遗尿症时处于治疗范围内。随着药物停用或减量，所有患者均完全康复。
丙戊酸钠诱发的遗尿症是一种罕见且可逆的副作用，发病年龄较小，以全身性癫痫发作为特征，且剂量较高。可能的机制包括抗利尿激素分泌不足、睡眠障碍和副交感神经系统亢进。临床医生应意识到这种不常见的副作用，以避免错误地调整治疗方向。
