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
Hauptverfasser: 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
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container_issue 8
container_start_page 197
container_title Revista de neurologiá
container_volume 77
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
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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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