Asterixis associated with sodium valproate

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Abstract
Intoxication with most anticonvulsants can produce asterixis. Asterixis rarely occurs with therapeutic serum anticonvulsant levels. Two patients with asterixis who were taking valproic acid and had serum levels within the therapeutic range are reported. Neither patient had clinical or laboratory evidence of hepatotoxicity. Only 1 other patient was reported with valproate-associated asterixis in the absence of toxic serum drug levels or hepatotoxicity. Asterixis seems to be due to a central effect of the drug unrelated to hepatotoxicity or sedation.

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