Abnormal ¹³C-Fatty Acid Breath Tests in Patients Treated With Valproic Acid

Abstract

Breath tests using fatty acids labeled with a stable isotope (carbon 13) were carried out on epileptic patients treated with valproic acid in order to detect abnormal fatty acid metabolism. The patients were given 13C-octanoic acid or 13C-palmitic acid orally, and expired air was collected at appropriate intervals for the analysis of 13CO2 content by a mass spectrometer. Eight patients were tested in the palmitic acid breath test and nine patients in the octanoic acid breath test. Controls for these tests were patients treated with antiepileptic drugs other than valproic acid and unmedicated cerebral palsy patients. In the valproic acid-treated group, 13C recovery was reduced by 56% in seven hours on the 13C-palmitic acid breath test, while the octanoic acid breath test showed a 52% reduction in one hour. This suppression of fatty acid oxidation was significantly correlated with dose of valproic acid in both tests. No influence of other drugs was detected, and the effect of administered carnitine was not conclusive. This study demonstrates the usefulness of 13C-labeled fatty acid breath tests in clinical practice.

Electrogastrography in children with cerebral palsy: Abnormal postprandial response to both fast- and slow-emptying meals

“…The diagnosis of CP and whether NF had been performed were verified by review of the medical records. Patients with information in the records indicating problems with breath test sampling, known or suspected immunological reactions against dietary proteins, in need for continuous treatment with prokinetic medication or use of valproic acid (interferes with breath test for GE [15]) were not eligible for inclusion. Families of eligible patients were contacted by telephone for information and asked to participate in the study.…”