FULMINANT PROGRESSION OF DEMYELINATING DISEASE AFTER VALPROATE-INDUCED ENCEPHALOPATHY

We report the clinical, radiologic, and pathologic features of a patie nt who had fulminant demyelinating disease and who experienced acute p rogression of his disease after an episode of valproate-induced hypera mmonemic encephalopathy. The role hyperammonemia played in the progres sion of the demyelination is uncertain. This case raises concern of a possible risk with the use of valproic acid in the subset of patients with fulminant demyelinating disease.