Prompt Reversing the Neurologic and Cardiac Manifestations of Valproate Poisoning by Hemodialysis: A Case Report

SV (sodium valproate) is an antiepileptic drug that is often prescribed for epilepsy, bipolar disorders, and migraine. We reported an SV intoxicated case that cardiac and neurologic abnormalities were promptly responded to hemodialysis (HD). She ingested a large amount of SV (۱۵۰ pills of SV ۲۰۰mg) for a suicide attempt. She was initially alert but her Glasco coma scale (GCS) decreased to ۶ thought ۱۱ hours. However, valproate (>۱۵۰mg/l) and ammonia serum (۱۶۴µg/dL) levels were not excessively elevated. The serial electrocardiography (ECG) showed QT prolongation and a signs of sodium channel block such as dominant R wave in AVR lead and T-wave inversion in the precordial leads. She had low level of calcium and potassium serum levels. Supportive treatment, charcoal, and L-carnitine, were not effective and HD was started due to the resistant cardiac and neurologic symptoms. After a ۳-hour HD session, decreased GCS, pathological ECG findings, and laboratory abnormalities dramatically disappeared. In conclusion, HD is an effective and rapid response treatment for Valproate-induced loss of consciousness and life-threatening cardiac abnormality.

کلیدواژه ها:

hemodialysis ، Valproate Poisoning ، Cardiac Manifestations ، Neurologic manifestations