Valproate-induced coma with ketosis and carnitine insufficiency.

Abstract

We observed two patients who developed coma following administration of valproate in dosages of 32 to 40 mg/kg per day. Valproate levels were within the therapeutic range, and results of liver function studies were normal. Both patients had ketosis and adipic aciduria. Plasma free carnitine levels were decreased during coma and after recovery. One patient excreted ethylmalonic acid, butyrylcarnitine, and glutarylcarnitine during and after resolution of coma, suggesting a multiple acyl coenzyme A dehydrogenation defect. Low serum carnitine levels may predispose patients to development of altered consciousness when treated with valproate.

• Authors: W J Triggs, T P Bohan, S N Lin, L J Willmore
• Journal: Archives of neurology (Arch Neurol) Vol. 47 Issue 10 Pg. 1131-3 (Oct 1990) ISSN: 0003-9942 [Print] United States
• PMID: 2121122 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't, Research Support, U.S. Gov't, P.H.S.)

Chemical References

• Acids
• Valproic Acid
• Carnitine

Topics

• Acids (urine)
• Adult
• Carnitine (deficiency)
• Coma (chemically induced, metabolism)
• Epilepsies, Partial (drug therapy)
• Epilepsy, Temporal Lobe (drug therapy)
• Female
• Humans
• Ketosis (chemically induced, metabolism)
• Valproic Acid (adverse effects, therapeutic use)