Abstract
We present a woman with epilepsy secondary to a lesion in the left frontal lobe. She developed episodes of disorientation and behavioral changes. She was taking valproic acid (1500mg/day), topiramate (200mg/day), and phenobarbital (100mg/day). During an episode, the EEG revealed moderate encephalopathy and ammonia levels were increased (195μg/dL, reference range: 11–60μg/dL). Episodes ceased after withdrawal of valproic acid.
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