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Mohammed Salhab, Omair Tahir, Abdullah Quddus, Adil Bhutta and Taro Minami
We present a case of acute valoproic acid intoxication induced hyperammonemia encephalopathy and coma in a young man with a remarkably normal liver function test. L-Carnitine was used in addition to supportive management.
Patient mental status improved within 24 hours and VPA and ammonia levels were declining until normalized. Serial liver function tests, including the synthetic functions, were performed and they were only remarkable for mildly elevated aspartate aminotransferase on presentation and were normal throughout the admission course.