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Hibar, Julie Absil, Saud Alhusaini, et al

We also measured serine threonine dehydratase (SDS) activity in the liver and skeletal muscle

[DOI] [PMC free article] [PubMed] [Google Scholar] DeCarli LM, Lieber CS

While you should have suspicion for this pathology in any patient presenting with altered mental status on valproic acid, the following factors may place the patient at an increased risk for this complication: Anticonvulsant polytherapy and medication interactions Medications such as topiramate, phenytoin, carbamazepine, and phenobarbital have been associated with increased ammonia levels when used in conjunction with valproic acid Renal failure Hepatic failure Carnitine deficiency: Carnitine assists with the elimination of valproic acid and minimizes the formation of harmful valproic acid metabolites

Comparative Efficacy and Safety of Thrombectomy Versus Thrombolysis for Large Vessel Occlusion in Acute Ischemic Stroke: A Systemic Review Cureus doi: 10.7759/cureus.72323 Manuel J, Barot KS, Mayow AH, Modi D, Tariq M, Hussain J, Waheed MD, Kutiyana S