丙戊酸钠脑病2例报告

Valproate-induced hyperammonemic encephalopathy:2 case reports

丙戊酸钠脑病(VHE)为丙戊酸(VPA)严重但极为罕见的不良反应,多发生于服用VPA数天至数周后,临床主要表现为急性发作的意识障碍,大多数患者血氨升高,但肝功能正常,主要的治疗方式为停用VPA。现报道2例武汉市第一医院服用VPA数天及1 a后出现VHE的病例,均以间断发作性意识障碍及行为异常为临床表现,以提高对该病的认识。

Valproate-induced hyperammonemic encephalopathy(VHE)is a rare central nervous system adverse effect of valproate that is characterized by acute impaired consciousness,which usually occurs days to weeks after taking VPA.Most patients have elevated serum ammonia but normal liver function.The discontinuation of VPA is currently the mainstay of treatment for VHE.In this manuscript,we report 2 cases of VHE in our hospital after several days of taking VPA and one year later,both of which are characterized by intermittent paroxysmal disturbance of consciousness and behavior,so as to improve the understanding of the disease.