Sodium Valproate

Epidemiology and Risk Factors

Pathophysiology

Aetiology

Clinical Features

Mild:

  • Nausea
  • Drowsiness
  • Confusion

Severe:

  • Cerebral oedema
  • Metabolic derangement
    • Metabolic acidosis
    • Hypernatraemia
    • Hypoglycaemia
    • Hyperammonaemia

Assessment

History:

Exam:

Investigations

Bedside:

Laboratory:

  • Blood
    • Valproate level
      Poor correlation between level and toxicity.

Imaging:

Other:

Diagnostic Approach and DDx

Management

  • Supportive care
  • Consider L-carnitine if hepatic dysfunction or hyperammonaemia

Resuscitation:

Specific therapy:

  • Pharmacological
  • Procedural
  • Physical

Supportive care:

Disposition:

Preventative:

Marginal and Ineffective Therapies

Anaesthetic Considerations

Complications

Prognosis

Key Studies

References

  1. Bersten, A. D., & Handy, J. M. (2018). Oh’s Intensive Care Manual. Elsevier Gezondheidszorg.