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Nezavest pri povišanem plazemskem amonijevem ionu in normalnem delovanju jeter = Uncousciousness due to hyperammonemia with normal liver function
Ambrožič, Jana, kardiologinja ; Brvar, Miran ; Bunc, Matjaž
One of the causes of acute unconsciousness is hyperammonemia, which is in adult patient mostly related to liver dysfunction. Valproic acid, used as an antiepileptic drug, might be the causeoi ...elevated plasma ammonia without signsof liver failure. We report on two patients with acute unconsciousness and hyperammonemia in the absence of liver dysfunction. In the first case hyperammonemia appeared at chronic valproic acid therapy and valproic acid within the therapeutic range. In the second case acute valproic acid overdose due to suicide attempt caused hyperammonemia with valproic acid level above the therapeutic range. In patients presented with acute mental status changes plasma ammonia is an important screening test. Acute valproic acid overdose aswell as chronic valproic acid therapy might result in hyperammonemia withoutliver dysfunction.
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