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Reversible dementia and apparent brain atrophy during valproate therapy
Author(s) -
Papazian Oscar,
Canizales Elizabeth,
Alfonso Israel,
Archila Ricardo,
Duchowny Michael,
Aicardi Jean
Publication year - 1995
Publication title -
annals of neurology
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 4.764
H-Index - 296
eISSN - 1531-8249
pISSN - 0364-5134
DOI - 10.1002/ana.410380423
Subject(s) - atrophy , magnetic resonance imaging , dementia , medicine , etiology , epilepsy , central nervous system disease , degenerative disease , complication , neuroimaging , pediatrics , disease , radiology , psychiatry
Two children developed severe cognitive and behavioral deterioration suggestive of a degenerative disease while being treated with sodium valproate for idiopathic, localization‐related epilepsy with centrotemporal spikes. Magnetic resonance imaging revealed Marchked central and generalized cortical and cerebellar atrophy. In both patients, clinical symptoms and signs cleared in a few weeks following valproate withdrawal. The magnetic resonance imaging appearance improved within 3 months in 1 of the patients and normalized in both after 6 and 12 months. No metabolic changes were associated with the clinical or imaging abnormalities. Although the mechanism of this rare idiosyncratic complication of valproate therapy is unknown, we advocate discontinuing valproate therapy in all epileptic patients with neuromental deterioration or brain atrophy of unknown etiology.