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- Hipólito Nzwalo, Leonor Carrapatoso, Fátima Ferreira, and Carlos Basilio.
- Neurology Department, Faro Hospital, Faro, Portugal. nzwalo@gmail.com
- Epileptic Disord. 2013 Jun 1; 15 (2): 207-10.
AbstractHyperammonaemic encephalopathy is a rare and potentially fatal complication of valproic acid treatment. The clinical presentation of hyperammonaemic encephalopathy is wide and includes seizures and coma. We present a case of hyperammonaemic coma precipitated by sodium valproate use for symptomatic epilepsy in a patient with unrecognised portosystemic shunt, secondary to earlier alcoholism. The absence of any stigmata of chronic liver disease and laboratory markers of liver dysfunction delayed the recognition of this alcohol-related complication. The portal vein bypass led to a refractory, valproic acid-induced hyperammonaemic coma. The patient fully recovered after dialysis treatment.
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