Parkinsonian Syndrome in Childhood After Sodium Valproate Administration

Reversible parkinsonism induced by prolonged treatment with valproate

“…In conclusion, our case reports, together with the three other studies [2,4,21], call attention to the fact that VPA can induce parkinsonism and that therefore particular care must be taken when VPA is administered to elderly patients, in order to identify promptly the specific parkinsonian signs of toxicity.…”

“…As other laboratory investigations were normal, and no relapses of parkinsonian symptoms were observed in the year following the VPA withdrawal, we suggest that both patients represent two further examples of VPA-induced parkinsonism. Although several previous reports [2,4,21] have described cases of parkinsonism induced by VPA, we thought that the present two patients were worth describing because the parkinsonian syndrome appeared at an age that is the most common age of onset of Parkinson's disease [10], while patients reported in previous descriptions were in their childhood or early adulthood [2,4,21], and because in our patients parkinsonism was not accompanied by cognitive disturbances or dementia or by brain pseudoatrophy, i.e. reversible ventricular dilatation and brain shrinkage, which had been described in four young epileptic patients [17,19,23].…”

“…Transient parkinsonism owing to VPA administration was recently described in three reports [2,4,21]: in a 12-year-old child [2], parkinsonism accompanied by cognitive disturbances appeared 7 days after treatment; in two young epileptic patients parkinsonism appeared shortly after beginning treatment and was characterized by prominent bradykinesia and bradyphrenia [2]. A prospective study [4] of 36 patients concluded that a syndrome of reversible parkinsonism and cognitive impairment may develop in patients who have been treated with VPA for more than 12 months.…”

Syndrome démentiel et extrapyramidal iatrogène : effet secondaire rare de l’association acide valproïque-aspirine

“…Les effets secondaires les plus sévères mais exceptionnels sont digestifs (hépatites, pancréatites [1]) et leur risque de survenue est majoré par la coprescription d'autres anti-épileptiques. Des syndromes parkinsoniens transitoires ont été rapportés chez des enfants et des adultes jeunes [2,3], de même qu'un cas de démence réversible [4]. Treize observations de syndromes parkinsoniens progressifs et réversibles à l'arrêt complet du traitement par acide valproïque avec dosage sérique normal ont été publiées [5][6][7].…”

Long-Term Outcome with Divalproex in Children and Adolescents with Bipolar Disorder

“…Important side effects reported with divalproex in children and adolescents include weight gain (Demir and Aysun 2000;Novak et al 1999), liver failure (Dreifuss et al 1987;Scheffner 1986), polycystic ovarian syndrome (PCOS; Eberle 1998;Geller 1997;Irwin and Masand 1998;Isojarvi et al 1993), hyperandrogenism (Isojarvi et al 1993), thrombocytopenia (Allarakhia et al 1996), pancreatitis (Asconape et al 1993;Wyllie et al 1984), hypothyroidism (Eiris-Punal et al 1999Salvatoni et al 1983), cognitive dysfunction (Armon et al 1996;Schmidt et al 1995;Straussberg et al 1998;Vaquerizo et al 1995), and parkinsonism (Alvarez-Gomez et al 1993). The long-term tolerability of divalproex in juvenile bipolar disorder is unknown.…”