Valproate enduced encephalopathy in a psychiatric patient with normal liver function tests

Sodium valproate is a broad spectrum antiepileptic drug (AED) and is being widely used in various neuro-psychiatric conditions. It can cause hyper-ammonemic encephalopathy (HE) especially when used with other anti-epileptics like topiramate, phenobarbitone, phenytoin etc. Here we describe such a patient who was taking valproate for bipolar disorder with no other AEDs and earlier misdiagnosed as viral encephalitis, which on further evaluation was found to be suffering from HE. The patient was managed accordingly and recovered completely.
 

Keywords: Sodium valproate, Hyperammonemic encephalopathy, Antiepileptic drugs