STUPOROUS STATES DURING SODIUM VALPROATE THERAPY - HYPOTHESES ON PATHOGENESIS

  • 1 January 1981
    • journal article
    • research article
    • Vol. 137  (4) , 241-254
Abstract
In 11 patients with complex partial epileptic seizures stuporous states were observed during treatment with valproate (VPA) (2 cases), with VPA and phenobarbitone (PB) (4 cases) or with VPA, PB and a 3rd anti-epileptic drug (5 cases). Based on 3 characteristic cases, an attempt was made to define the role of VPA, the nature of the stuporous states and the origin of digestive disorders which often heralded the onset of behavioral disorders. Several clinical studies suggested the direct responsibility of VPA even if the adverse effects were potentiated by other anti-epileptic drugs. Stuporous states were not due to VPA overdose and did not depend on the mode of administration. No correlation was found between electroclinical signs and plasma or CSF levels of the different anti-epileptic drugs. Reported data suggested a paradoxical epileptogenic role for VPA on complex partial seizures; there existed a close similarity of electroclinical findings between spontaneous epileptic seizures and stuporous states during DPA treatment. Digestive disorders resulted from a central mechanism and not from digestive tract intolerance. In some cases, it was likely that partial seizures with digestive symptoms and signs did occur.

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