RESUMEN
We report a case of a 34-year-old woman who was in temporary delirium and hyperammonemia during treatment of bipolar affective disorder with valproate. Patient showed delirium after 20 days of treatment, while the serum valproate level was within the therapeutic range without any sign of hepatic insufficiency. However, the patient had increased serum ammonia level (121 microg/mL), and valproate was discontinued due to suspicion of valproate-induced hyperammonemic encephalopathy (VHE). Serum valproate level was normalized with reduced delirium after valproate has been discontinued. Few VHE in psychiatric literature has been documented, because of possible confusion between VHE and preexisting psychiatric symptoms. Clinicians should be cautious about the potential risk for hyperammonemic encephalopathy caused by valproate medication.
Asunto(s)
Adulto , Femenino , Humanos , Amoníaco , Delirio , Insuficiencia Hepática , Hiperamonemia , Trastornos del Humor , Ácido ValproicoRESUMEN
Objective To explore the effect of vaproate sodium (VP) on Bcl-2 and Bax expression of hippocampus in seizures rats induced by pentylenetetrazole(PTZ).Methods Twenty-four adult Wistar rats were randomly divided into normal control (NC) group, PTZ group and VAP group. A dose of PTZ [35 mg/(kg?day)] was intraperitoneally injected into the rats of PTZ group and VAP group until the kindling criterion was reached. After kindling, the rats of VAP group were administered intraperitoneally with VAP[15 mg/(kg?day)];the rats of PTZ group were administered intraperitoneally with normal saline. After 30 minutes, seizures were induced by administering PTZ intraperitoneally. The influence of VAP on Bcl-2 and Bax immmunoreactivity on hippocampus neurons was studied by immunohistochemistry method.Results Bax positive cells in hippocampus in PTZ group were more than in VAP group and NC group(all P