Abstract
In the treatment of epilepsy, selecting an appropriate antiepileptic drug for each individual patient requires matching the patient’s clinical needs with the agent’s specific pharmacological attributes. In many situations, the final choice of an antiepileptic drug may need a change due to the agent’s side-effect profile. The authors report a ten-year-old child with Lennox Gastaut syndrome who developed recurrence of seizures, hyperammonemic encephalopathy and cerebellar atrophy on valproate therapy. Valproate was discontinued and lamotrigine was added followed by good control of seizures. Cerebellar atrophy as a serious adverse side effect of valproate therapy, has been infrequently reported.
This is a preview of subscription content, log in via an institution to check access.
References
Conry JA, Ng YT, Paolicchi JM, et al. Clobazam in the treatment of Lennox-Gastaut syndrome. Epilepsia. 2009;50:1158–66.
Trevathan E, Murphy CC, Yeargin-Allsopp M. Prevalence and descriptive epidemiology of Lennox-Gastaut syndrome among Atlanta children. Epilepsia. 1997;38:1283–8.
Verrotti A, Trotta D, Morgese G, Chiarelli F. Valproate induced hyperammonemic encephalopathy. Metab Brain Dis. 2002;17:367–73.
Kalra V. Management of childhood epilepsy. Indian J Pediatr. 2003;70(2):147–51.
Aneja S, Newton RW. Newer anti-epileptic drugs. Indian J Pediatr. 1996;63(2):233–41.
Rath A, Naryanan TJ, Chowdhary GVS, Murthy JMK. Valproate-induced hyperammonemic encephalopathy with normal liver function. Neurol India. 2005;53:226–28.
McLachlan RS. Pseudoatrophy of the brain with valproic acid monotherapy. Can J Neurol Sci. 1987;14:294–96.
Papazian O, Canizales E, Alfonso I, Archila R, Duchowny M, Aicardi J. Reversible dementia and apparent brain atrophy during valproate therapy. Ann Neurol. 1995;38:687–91.
Guerrini R, Belmonte A, Canapicchi R, Casalini C, Perucca E. Reversible pseudoatrophy of the brain and mental deterioration associated with valproate treatment. Epilepsia. 1998;39:27–32.
Contributions
GV collected the data and wrote the paper which was edited and corrected by SK. SB helped in clinical case work and AP interpreted the radiology findings.
Conflict of Interest
None.
Role of Funding Source
None.
Author information
Authors and Affiliations
Corresponding author
Rights and permissions
About this article
Cite this article
Ghosh, V.B., Kapoor, S., Prakash, A. et al. Cerebellar Atrophy in a Child with Valproate Toxicity. Indian J Pediatr 78, 999–1001 (2011). https://doi.org/10.1007/s12098-010-0332-6
Received:
Accepted:
Published:
Issue Date:
DOI: https://doi.org/10.1007/s12098-010-0332-6