Valproic acid- induced early diagnosed encephalopathy

Valproic acid-induced encephalopathy is a rarely seen but serious complication that may lead to death. It can be completely treated if early diagnosis is made and valproic acid (VPA) is discontinued. It is clinically presented as consciousness changes that range from sleepiness to lethargy and coma, focal or bilateral neurological findings, seizure, vomiting, and slow waves on electroencephalography (EEG). An 18 year old female patient presented to our policlinic for the follow up of epilepsy. Her neurological examination was normal. The patient complained of headache. EEG showed disordered background activity at both hemispheres with symmetric delta activity at a frequency of 3-4 Hz, along with sharp paroxysms lasting 1-2 seconds. After discontinuation of the drug, EEG video monitoring showed a decrease in the sharp paroxysms the day after the drug. On the fourth day, the EEG returned to normal. We conclude that encephalopathy can be early diagnosed with EEG in VPA users. J. Exp. Clin. Med., 2013; 30:385-387