A Case of Valproate-induced Reversible Parkinsonism

J Korean Neurol Assoc > Volume 18(5); 2000 > Article

Journal of the Korean Neurological Association 2000;18(5): 654-656.

Valproate에 의해 유발된 가역적 파킨슨증 1예

김선곤, 오승헌 ·김원주

연세대학교 의과대학 영동세브란스병원 신경과학교실

A Case of Valproate-induced Reversible Parkinsonism

Sun-Kon Kim, M.D., Seung-Hun Oh, M.D., Won-Joo Kim, M.D.

Department of Neurology, Yongdong Severance Hospital, Yonsei University College of Medicine

Abstract

Valproate is one of the most popular conventional anti-epileptic drugs. It has many side effects and in rare cases, it may result in the development of parkinsonian syndromes. The parkinsonism with valproate shows insidious onset and reversible symptoms after drug withdrawal. We observed a 69-year-old woman with resting tremor, bradykinesia, cog-wheel rigidity after 2 months of valproate use. She had been suffering from epilepsy for 30 years. Her seizures were well controlled with valproate, but parkinsonian symptoms slowly progressed with doses of 1200 mg/day of valproate. After 4 months, we discontinued the doses of valproate which led to subjective and objective improvement of the parkinsonian features. The mechanism of this side effect is not well established, but GABAergic neurotransmission or mitochondrial respiratory chain may possibly be related. J Korean Neurol Assoc 18(5):654~656, 2000 Key Words : Valproic acid, Parkinson disease/Secondary