1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-2-60-a 10.15844/pedneurbriefs-2-8-6 Toxic Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Valproate Toxicity http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 08 1988 01 08 2016 2 8 60 60 Copyright: © 1988 The Author(s) 1988 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Gastritis with valproate therapy

Gastritis and erosion of the gastric mucosa is reported in 10 children who presented with feeding difficulties after long-term treatment with divalproex sodium (Depakote) and valproic acid (Depakene) at the Departments of Neurology, Pediatrics, and Pediatric Surgery, University of Oklahoma Health Sciences Center, Oklahoma City.

 Gastric Mucosa Anorexia and Refusal Clinical Improvement

Gastritis and erosion of the gastric mucosa is reported in 10 children who presented with feeding difficulties after long-term treatment with divalproex sodium (Depakote) and valproic acid (Depakene) at the Departments of Neurology, Pediatrics, and Pediatric Surgery, University of Oklahoma Health Sciences Center, Oklahoma City. Anorexia and refusal to eat were complicated by vomiting in 8 patients, abdominal pain in 5, weight loss in 3, and diarrhea in 2. Endoscopy confirmed erosive gastritis. Treatment with oral antacids (Maalox) and cimetidine resulted in clinical improvement. [1]

COMMENT. Gastrointestinal disturbances are common at the initiation of valproate therapy but have not previously been reported following its long term use. The diagnosis of gastritis in mentally retarded patients with epilepsy may be difficult, and delay may lead to gastric erosion, resulting in malnutrition, weight loss, and dehydration. If liver and pancreas disease has been excluded as a side-effect, the treatment of valproate-induced gastritis includes antacids and an alteration of anticonvulsant regimen in some cases.

 Marks WA Morris MP Bodensteiner JB Grunow JE Bobele GB Hille MR Gastritis with valproate therapy Arch Neurol 1988 Aug 45 8 903 905 10.1001/archneur.1988.00520320101022 2899428