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-6-71-a 10.15844/pedneurbriefs-6-9-10 Antiepileptic Drugs Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Valproate-Induced Cerebral Edema 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 09 1992 01 07 2016 6 9 71 71 Copyright: © 1992 The Author(s) 1992 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. Cerebral edema following acute sodium valproate overdose

A case of cerebral edema resulting from acute sodium valproate poisoning in a 19 year old male is reported from Northwick Park and East Birmingham Hospitals, UK.

 Valproate Cerebral Edema Gastrostomies Stoma

A case of cerebral edema resulting from acute sodium valproate poisoning in a 19 year old male is reported from Northwick Park and East Birmingham Hospitals, UK. On admission the patient was unconscious and the plasma valproate concentration was 900 mg/L. He had taken 1200 mg of sodium valproate along with 1500 mg of aspirin. The salicylate blood level was 70 mg/L. CT showed gross cerebral edema with slit-like ventricles and absence of cortical sulci and basal cisterns. Gastric lavage, fluid restriction and IV dexamethasone resulted in slow recovery. Acute complications included liver and renal dysfunction, hypocalcaemia and generalized muscle spasms. [1]

COMMENT. External leakage from feeding gastrostomies was reported in 4 of 8 children who received valproate sprinkle at the Hennepin County Medical Center, Minneapolis, MN [2]. Adherence of undissolved valproate particles to the exterior of the tube appeared to prevent the close approximation of the tube to the gastrostomies stoma. The problem was reduced by changing the tube more frequently or using a larger size tube.

 Khoo SH Leyland MJ Cerebral edema following acute sodium valproate overdose Clin Toxicol 1992 30 2 209 214 10.3109/15563659209038632 1588670 Jones-Saete C Kriel RL Cloyd JC External leakage from feeding gastrostomies in patients receiving valproate sprinkle Epilepsia 1992 Jul-Aug 33 4 692 695 10.1111/j.1528-1157.1992.tb02349.x 1628586