Cerebral and cerebellar pseudoatrophy associated with valproic acid. Report of three pediatric cases
Cerebral and cerebellar pseudoatrophy is a rare adverse effect of valproic acid (VPA) that we need to be aware of, due to its diagnostic and therapeutic implications. We report three cases of children between 5 and 9 years old, with epilepsy and previous normal brain magnetic resonance imaging, who...
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| Veröffentlicht in: | Revista de neurologiá 2023-10, Vol.77 (8), p.197 |
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| container_title | Revista de neurologiá |
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| creator | Ordoño-Saiz, M V Púa-Torrejón, R C Justel-Rodríguez, M Arias-Vivas, E Heppe-Montero, M González-Alguacil, E Duat-Rodríguez, A Ruiz-Falcó-Rojas, M L García-Peñas, J J Gutiérrez-Delicado, E Soto-Insuga, V |
| description | Cerebral and cerebellar pseudoatrophy is a rare adverse effect of valproic acid (VPA) that we need to be aware of, due to its diagnostic and therapeutic implications.
We report three cases of children between 5 and 9 years old, with epilepsy and previous normal brain magnetic resonance imaging, who were taking the drug at correct doses. Pseudoatrophy manifests subacutely with symptoms and images of cerebral and/or cerebellar atrophy, reversible after drug withdrawal.
This is a type of VPA-related encephalopathy, different from dose-dependent toxic encephalopathy, hyperammonaemic encephalopathy or encephalopathy related to liver failure. In children, it causes cognitive, motor, mood and behavioral deterioration, and may be accompanied by epileptic decompensation. Withdrawing the drug leads to complete clinical-radiological recovery, and reducing the dose leads to improvement. |
| doi_str_mv | 10.33588/rn.7708.2023186 |
| format | Article |
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We report three cases of children between 5 and 9 years old, with epilepsy and previous normal brain magnetic resonance imaging, who were taking the drug at correct doses. Pseudoatrophy manifests subacutely with symptoms and images of cerebral and/or cerebellar atrophy, reversible after drug withdrawal.
This is a type of VPA-related encephalopathy, different from dose-dependent toxic encephalopathy, hyperammonaemic encephalopathy or encephalopathy related to liver failure. In children, it causes cognitive, motor, mood and behavioral deterioration, and may be accompanied by epileptic decompensation. Withdrawing the drug leads to complete clinical-radiological recovery, and reducing the dose leads to improvement.</description><identifier>ISSN: 1576-6578</identifier><identifier>EISSN: 1576-6578</identifier><identifier>DOI: 10.33588/rn.7708.2023186</identifier><identifier>PMID: 37807884</identifier><language>eng ; spa</language><publisher>Spain</publisher><subject>Anticonvulsants - therapeutic use ; Brain - pathology ; Brain Diseases - chemically induced ; Brain Diseases - diagnosis ; Cerebellum - diagnostic imaging ; Child ; Child, Preschool ; Epilepsy - drug therapy ; Humans ; Neurotoxicity Syndromes - etiology ; Valproic Acid - adverse effects</subject><ispartof>Revista de neurologiá, 2023-10, Vol.77 (8), p.197</ispartof><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>315,782,786,27931,27932</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/37807884$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Ordoño-Saiz, M V</creatorcontrib><creatorcontrib>Púa-Torrejón, R C</creatorcontrib><creatorcontrib>Justel-Rodríguez, M</creatorcontrib><creatorcontrib>Arias-Vivas, E</creatorcontrib><creatorcontrib>Heppe-Montero, M</creatorcontrib><creatorcontrib>González-Alguacil, E</creatorcontrib><creatorcontrib>Duat-Rodríguez, A</creatorcontrib><creatorcontrib>Ruiz-Falcó-Rojas, M L</creatorcontrib><creatorcontrib>García-Peñas, J J</creatorcontrib><creatorcontrib>Gutiérrez-Delicado, E</creatorcontrib><creatorcontrib>Soto-Insuga, V</creatorcontrib><title>Cerebral and cerebellar pseudoatrophy associated with valproic acid. Report of three pediatric cases</title><title>Revista de neurologiá</title><addtitle>Rev Neurol</addtitle><description>Cerebral and cerebellar pseudoatrophy is a rare adverse effect of valproic acid (VPA) that we need to be aware of, due to its diagnostic and therapeutic implications.
We report three cases of children between 5 and 9 years old, with epilepsy and previous normal brain magnetic resonance imaging, who were taking the drug at correct doses. Pseudoatrophy manifests subacutely with symptoms and images of cerebral and/or cerebellar atrophy, reversible after drug withdrawal.
This is a type of VPA-related encephalopathy, different from dose-dependent toxic encephalopathy, hyperammonaemic encephalopathy or encephalopathy related to liver failure. In children, it causes cognitive, motor, mood and behavioral deterioration, and may be accompanied by epileptic decompensation. Withdrawing the drug leads to complete clinical-radiological recovery, and reducing the dose leads to improvement.</description><subject>Anticonvulsants - therapeutic use</subject><subject>Brain - pathology</subject><subject>Brain Diseases - chemically induced</subject><subject>Brain Diseases - diagnosis</subject><subject>Cerebellum - diagnostic imaging</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Epilepsy - drug therapy</subject><subject>Humans</subject><subject>Neurotoxicity Syndromes - etiology</subject><subject>Valproic Acid - adverse effects</subject><issn>1576-6578</issn><issn>1576-6578</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2023</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpNkEFLw0AQhRdRbK3ePckevSROspvs5CjFqlAQRM9hsjuhkbSJu4nSf2-KFTy9ebyPYeYJcZ1ArFSGeOd3sTGAcQqpSjA_EfMkM3mUZwZP_80zcRHCB4BWuoBzMVMGwSDquXBL9lx5aiXtnLQHw21LXvaBR9fR4Lt-s5cUQmcbGtjJ72bYyC9qe981VpJtXCxfue_8ILtaDhvPLHt2E-yn3FLgcCnOamoDXx11Id5XD2_Lp2j98vi8vF9HfaKTISImAw5y0IVNrIHKkQKqXJprQGPR1Gi4MHmVIYDJCo1ck62ICoaUa6cW4vZ373Tb58hhKLdNsId_dtyNoUzRaFSIUw8LcXNEx2rLrux9syW_L_-aUT8iW2ei</recordid><startdate>20231016</startdate><enddate>20231016</enddate><creator>Ordoño-Saiz, M V</creator><creator>Púa-Torrejón, R C</creator><creator>Justel-Rodríguez, M</creator><creator>Arias-Vivas, E</creator><creator>Heppe-Montero, M</creator><creator>González-Alguacil, E</creator><creator>Duat-Rodríguez, A</creator><creator>Ruiz-Falcó-Rojas, M L</creator><creator>García-Peñas, J J</creator><creator>Gutiérrez-Delicado, E</creator><creator>Soto-Insuga, V</creator><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7X8</scope></search><sort><creationdate>20231016</creationdate><title>Cerebral and cerebellar pseudoatrophy associated with valproic acid. 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Report of three pediatric cases</atitle><jtitle>Revista de neurologiá</jtitle><addtitle>Rev Neurol</addtitle><date>2023-10-16</date><risdate>2023</risdate><volume>77</volume><issue>8</issue><spage>197</spage><pages>197-</pages><issn>1576-6578</issn><eissn>1576-6578</eissn><abstract>Cerebral and cerebellar pseudoatrophy is a rare adverse effect of valproic acid (VPA) that we need to be aware of, due to its diagnostic and therapeutic implications.
We report three cases of children between 5 and 9 years old, with epilepsy and previous normal brain magnetic resonance imaging, who were taking the drug at correct doses. Pseudoatrophy manifests subacutely with symptoms and images of cerebral and/or cerebellar atrophy, reversible after drug withdrawal.
This is a type of VPA-related encephalopathy, different from dose-dependent toxic encephalopathy, hyperammonaemic encephalopathy or encephalopathy related to liver failure. In children, it causes cognitive, motor, mood and behavioral deterioration, and may be accompanied by epileptic decompensation. Withdrawing the drug leads to complete clinical-radiological recovery, and reducing the dose leads to improvement.</abstract><cop>Spain</cop><pmid>37807884</pmid><doi>10.33588/rn.7708.2023186</doi></addata></record> |
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| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; PubMed Central Open Access; PubMed Central |
| subjects | Anticonvulsants - therapeutic use Brain - pathology Brain Diseases - chemically induced Brain Diseases - diagnosis Cerebellum - diagnostic imaging Child Child, Preschool Epilepsy - drug therapy Humans Neurotoxicity Syndromes - etiology Valproic Acid - adverse effects |
| title | Cerebral and cerebellar pseudoatrophy associated with valproic acid. Report of three pediatric cases |
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