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SM Case Reports

Reversible Hyperammonemic Encephalopathy in a Patient with Schizophrenia

[ ISSN : 2473-0688 ]

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Received: 20-Jul-2017

Accepted: 26-Jul-2017

Published: 31-Jul-2017

Case Report | Volume 3 - Issue 4 | Article DOI :

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Roberto López-Bernabé¹, Andrea Miró-Andreu², and Claudia Patricia Gómez Cárdenas³*

¹ Department of Clinical Neurophysiology, Hospital General Universitario Morales Meseguer, Murcia, Spain
² Department of Clinical Neurophysiology, Hospital General Universitario Reina Sofía, Murcia, Spain
³ Department of Clinical Neurophysiology, Hospital de Molina de Segura, Murcia, Spain

Corresponding Author:

Roberto López-Bernabé, Department of Clinical Neurophysiology, Hospital Universitario Morales Meseguer, Avda. Marqués de los Vélez S/N, 30008 Murcia, Spain, Email: rolobe85@hotmail.com

Keywords

Hyperammonemic encephalopathy; Hiperammonemia; Valproate acid; Adverse effect; Electroencephalography; Triphasic waves; Schizophrenia

Abstract

Introduction: Valproate acid (VPA) is a very common treatment in neurology and psychiatric pathologies. Valproate-associated Hyperammonemic Encephalopathy (VHE) is a rare and serious side effect of the VPA treatment.

Case report: We present the case of an adolescent with a recent diagnosis of schizophrenia, hospitalized for psychotic decompensation and generalized epileptic seizures, with no personal or family history of epilepsy. After progressive introduction of VPA, the patient developed an acute mental state characterized by lethargy, cognitive deceleration, confusion and verbal response lentification, suggestive of encephalopathy. Laboratory tests showed a hyperammonemia with normal hepatic function, and the electroencephalogram (EEG) showed severe diffuse slowing with bifrontally predominant triphasic waves, a characteristic pattern of metabolic encephalopathies.

Conclusion: This case shows an important and infrequent secondary effect of VPA, as well as the importance of EEG in the study of patients with altered state of consciousness.

Citation

López-Bernabé R, Miró-Andreu A and Cárdenas CPG. Reversible Hyperammonemic Encephalopathy in a Patient with Schizophrenia. SM J Case Rep. 2017; 3(4): 1053.