Valproate-induced Parkinsonism in epilepsy patients.
Identifieur interne : 002976 ( PubMed/Curation ); précédent : 002975; suivant : 002977Valproate-induced Parkinsonism in epilepsy patients.
Auteurs : Dominic Jamora [Singapour] ; Shih-Hui Lim ; Andrew Pan ; Louis Tan ; Eng-King TanSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 2007.
English descriptors
- KwdEn :
- MESH :
- chemical , adverse effects : Anticonvulsants, Valproic Acid.
- chemically induced : Parkinsonian Disorders.
- drug therapy : Epilepsy.
- Adult, Chi-Square Distribution, Female, Humans, Male, Middle Aged.
Abstract
We systematically examined 226 epilepsy patients in a tertiary-referral center and found 6 (5.04%) to have valproate-induced Parkinsonism. There was a significantly higher prevalence of patients with Parkinsonism in the group of patients treated with valproate compared to those who were on other antiepileptic drugs (6 [5.04%] of 119 vs. 0 [0%] of 107; chi2 = 5.54; P = 0.025). These six patients had been on valproate for more than 3 years (mean, 75.67 +/- 25.32 months) at an average dose of 750 +/- 273.86 mg/day. The valproate doses were decreased or discontinued with supplementation from another antiepileptic medication. The mean UPDRS motor score significantly improved from 10.67 +/- 5.1 to 4.75 +/- 2.75 (P < 0.05). There was no relapse of seizures. Clinicians working in tertiary-referral centers should have a high index of suspicion for valproate-induced Parkinsonism. Early recognition and switching into another antiepileptic medication may help reduce unnecessary suffering in these patients.
DOI: 10.1002/mds.21188
PubMed: 17115396
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pubmed:17115396Le document en format XML
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<author><name sortKey="Jamora, Dominic" sort="Jamora, Dominic" uniqKey="Jamora D" first="Dominic" last="Jamora">Dominic Jamora</name>
<affiliation wicri:level="1"><nlm:affiliation>Department of Neurology, National Neuroscience Institute, Singapore.</nlm:affiliation>
<country xml:lang="fr">Singapour</country>
<wicri:regionArea>Department of Neurology, National Neuroscience Institute</wicri:regionArea>
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<author><name sortKey="Lim, Shih Hui" sort="Lim, Shih Hui" uniqKey="Lim S" first="Shih-Hui" last="Lim">Shih-Hui Lim</name>
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<author><name sortKey="Pan, Andrew" sort="Pan, Andrew" uniqKey="Pan A" first="Andrew" last="Pan">Andrew Pan</name>
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<author><name sortKey="Tan, Louis" sort="Tan, Louis" uniqKey="Tan L" first="Louis" last="Tan">Louis Tan</name>
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<author><name sortKey="Tan, Eng King" sort="Tan, Eng King" uniqKey="Tan E" first="Eng-King" last="Tan">Eng-King Tan</name>
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<author><name sortKey="Tan, Louis" sort="Tan, Louis" uniqKey="Tan L" first="Louis" last="Tan">Louis Tan</name>
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<term>Female</term>
<term>Humans</term>
<term>Male</term>
<term>Middle Aged</term>
<term>Parkinsonian Disorders (chemically induced)</term>
<term>Valproic Acid (adverse effects)</term>
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<front><div type="abstract" xml:lang="en">We systematically examined 226 epilepsy patients in a tertiary-referral center and found 6 (5.04%) to have valproate-induced Parkinsonism. There was a significantly higher prevalence of patients with Parkinsonism in the group of patients treated with valproate compared to those who were on other antiepileptic drugs (6 [5.04%] of 119 vs. 0 [0%] of 107; chi2 = 5.54; P = 0.025). These six patients had been on valproate for more than 3 years (mean, 75.67 +/- 25.32 months) at an average dose of 750 +/- 273.86 mg/day. The valproate doses were decreased or discontinued with supplementation from another antiepileptic medication. The mean UPDRS motor score significantly improved from 10.67 +/- 5.1 to 4.75 +/- 2.75 (P < 0.05). There was no relapse of seizures. Clinicians working in tertiary-referral centers should have a high index of suspicion for valproate-induced Parkinsonism. Early recognition and switching into another antiepileptic medication may help reduce unnecessary suffering in these patients.</div>
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<Abstract><AbstractText>We systematically examined 226 epilepsy patients in a tertiary-referral center and found 6 (5.04%) to have valproate-induced Parkinsonism. There was a significantly higher prevalence of patients with Parkinsonism in the group of patients treated with valproate compared to those who were on other antiepileptic drugs (6 [5.04%] of 119 vs. 0 [0%] of 107; chi2 = 5.54; P = 0.025). These six patients had been on valproate for more than 3 years (mean, 75.67 +/- 25.32 months) at an average dose of 750 +/- 273.86 mg/day. The valproate doses were decreased or discontinued with supplementation from another antiepileptic medication. The mean UPDRS motor score significantly improved from 10.67 +/- 5.1 to 4.75 +/- 2.75 (P < 0.05). There was no relapse of seizures. Clinicians working in tertiary-referral centers should have a high index of suspicion for valproate-induced Parkinsonism. Early recognition and switching into another antiepileptic medication may help reduce unnecessary suffering in these patients.</AbstractText>
<CopyrightInformation>Copyright 2006 Movement Disorder Society.</CopyrightInformation>
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