Fatal hepatic necrosis associated with multiple anticonvulsant therapy
Smith, D.W.; Cullity, G.J.; Silberstein, E.P.
Australian and New Zealand Journal of Medicine 18(4): 575-581
1988
ISSN/ISBN: 0004-8291 PMID: 3143348 Document Number: 325835
We report six fatal cases of hepatic necrosis in childern associated with multiple anticonvulsant therapy. There was insufficient evidence to incriminate any single drug or combination of drugs, but it is noteworthy that sodium valproate was involved in only one case. We consider that an idiosyncratic metabolic reaction to the anticonvulsants was most likely. In five of the six cases hepatic failure was immediately preceeded by a prolonged fit and we speculate that metabolic change from excessive neuronal activity may unmask the hepatotoxicity of anticonvulsants.