Abstract
Two adults, aged 32 and 37, with focal epilepsy developed hyperammonemic encephalopathy when treated with a combination of valproate (VPA) and topiramate (TPM) at the University of Marburg, Germany.
Highlights
Immunotherapy with plasma exchange or immunoglobulin are successful in lessening severity of infection-triggered symptoms of obsessive compulsive disorder and Tourette syndrome
Two adults, aged 32 and 37, with focal epilepsy developed hyperammonemic encephalopathy when treated with a combination of valproate (VPA) and topiramate (TPM) at the University of Marburg, Germany
The addition of phenobarbital may increase the risk of VPA/TPM encephalopathy by decreasing ammonia detoxification in the liver
Summary
Two adults, aged 32 and 37, with focal epilepsy developed hyperammonemic encephalopathy when treated with a combination of valproate (VPA) and topiramate (TPM) at the University of Marburg, Germany. Immunotherapy with plasma exchange or immunoglobulin are successful in lessening severity of infection-triggered symptoms of obsessive compulsive disorder and Tourette syndrome. The effects of immunotherapy in patients with chronic symptoms unrelated to PANDAS remains to be determined.
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