Tijdschrift voor Gerontologie en Geriatrie

, Volume 40, Issue 1, pp 29–33 | Cite as

Cognitieve stoornissen en parkinsonisme bij gebruik van valproïnezuur

  • L. Schreur
  • C. W. Middeljans-Tijssen
  • G. J. D. Hengstman
  • M. G. M. Olde Rikkert
Klinische les

Samenvatting

Twee patiënten presenteerden zich met cognitieve stoornissen en parkinsonisme-achtige verschijnselen tijdens de behandeling met valproïnezuur. Bij beide patiënten was er sprake van progressieve cognitieve stoornissen en mobiliteitsproblemen. Na het staken van de valproïnezuur waren beide syndromen grotendeels of zelfs volledig reversibel. Er is een toenemende prevalentie en incidentie van epilepsie bij ouderen boven de 60 jaar en een groot gedeelte van deze patiënten wordt behandeld met valproïnezuur. Alle klinici die oudere patiënten behandelen dienen op de hoogte te zijn van het feit dat deze behandeling reversible cognitieve stoornissen en parkinsonisme kan veroorzaken, mogelijk door verminderde activiteit van mitochondrieel complex I functie.

Het staken van valproïnezuur wordt sterk aanbevolen bij alle patiënten die tijdens de behandeling cognitieve stoornissen, parkinsonisme of beide ontwikkelen.

Cognitive impairment and parkinsonism due to use of sodium valproate

Two patients presented with progressive cognitive impairment and parkinsonism related symptoms while being treated with sodium valproate. Both patients suffered from progressive cognitive decline and mobility disorders with an insidious onset over a period of months to years. After discontinuation of sodium valproate both debilitating symptoms resolved nearly completely.

There is a growing prevalence and incidence of epilepsy above the age of 60 and a great number of these patients are on sodium valproate treatment. All clinicians treating elderly patients should be aware of the fact that this treatment can cause reversible cognitive decline and parkinsonism probably due to impairment of mitochondrial complex I function. Discontinuation of sodium valproate is strongly recommended in all patients with development of cognitive impairment or parkinsonism or both during sodium valproate treatment.

Valproate parkinsonism cognitive impairment 

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Copyright information

© Bohn Stafleu van Loghum 2009

Authors and Affiliations

  • L. Schreur
    • 1
  • C. W. Middeljans-Tijssen
  • G. J. D. Hengstman
  • M. G. M. Olde Rikkert
  1. 1.

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