l‐Carnitine Supplementation in Childhood Epilepsy: Current Perspectives

@article{Vivo1998lCarnitineSI,
  title={l‐Carnitine Supplementation in Childhood Epilepsy: Current Perspectives},
  author={D. Vivo and T. Bohan and D. L. Coulter and F. Dreifuss and R. Greenwood and D. Nordli and W. Shields and C. Stafstrom and I. Tein},
  journal={Epilepsia},
  year={1998},
  volume={39}
}
Summary: In November 1996, a panel of pediatric neurologists met to update the consensus statement issued in 1989 by a panel of neurologists and metabolic experts on L‐carnitine supplementation in childhood epilepsy. The panelists agreed that intravenous L‐carnitine supplementation is clearly indicated for valproate (VPA)‐induced hepatotoxicity, overdose, and other acute metabolic crises associated with carnitine deficiency. Oral supplementation is clearly indicated for the primary plasmalemmal… Expand

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TLDR
Despite the lack of prospective, randomized clinical trials documenting efficacy of carnitine supplementation in preventing valproic acid–induced hepatotoxicity, the few limited studies available have shown carnitines supplementation to result in subjective and objective improvements along with increases in carnitINE serum concentrations in patients receiving valproi acid. Expand
Science review: Carnitine in the treatment of valproic acid-induced toxicity – what is the evidence?
TLDR
Carnitine supplementation during VPA therapy in high-risk patients is now recommended by some scientific committees and textbooks, especially paediatricians, and may also be valuable in those patients who develop VHT or VHE. Expand
[The decreased level of plasma carnitine in patients with epilepsy].
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  • Zhurnal nevrologii i psikhiatrii imeni S.S. Korsakova
  • 2017
TLDR
It was established that body weight, height and multidrug therapy are significantly associated with low level of free plasma in epileptic patients and some findings indicate that the number of AEDs used is a risk factor for carnitine deficiency. Expand
Carnitine as an antidote for acute valproate toxicity in children
  • S. Russell
  • Medicine
  • Current opinion in pediatrics
  • 2007
TLDR
Based on this recent literature, it seems reasonable to use carnitine for documented severe valproic acid toxicity, particularly in cases where patients present with coma, rising ammonia level, or valProic acid levels greater than 450 mg/l. Expand
Carnitine Deficiency in Chinese Children with Epilepsy on Valproate Monotherapy.
TLDR
Carnitine deficiency with valproate is more likely in females, those with transaminitis, and those receiving the drug for 1-12 months, than in healthy controls, which is more than twice as likely. Expand
Carnitine Deficiency in Chinese Children with Epilepsy on Valproate Monotherapy
ObjectiveTo explore the incidence and independent risk-factors of secondary carnitine deficiency in Chinese children with epilepsy on valproate monotherapy.MethodsThe free carnitine andExpand
Carnitine deficiency: Risk factors and incidence in children with epilepsy
TLDR
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The risk of asymptomatic hyperammonemia in children with idiopathic epilepsy treated with valproate: Relationship to blood carnitine status
TLDR
Epileptic children treated with VPA and free of neurological disabilities are at risk for hyperammonemia that may be associated with hypocarnitinemia, and patients will benefit from early recognition and preventive measures as carnitine supplementation. Expand
The Ketogenic diet: from molecular mechanisms to clinical effects
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Overall, the data reviewed indicate that considerable advances have been made in understanding the modes of action of the ketogenic diet, its efficacy and tolerability profiles and its potential role in different types of epilepsy. Expand
Potential relationships between transaminase abnormality and valproic acid clearance or serum carnitine concentrations in Japanese epileptic patients
TLDR
The initial hypothesis that the determinants of mild liver injury are prerequisites for more severe idiosyncratic hepatotoxicity with VPA is tested, while the results support the initial hypothesis, while also helping to clarify the mechanism of severe idiosyncratically hepatot toxicity with V PA. Expand
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Preliminary data suggest that Carnitine treatment may benefit high-risk, symptomatic patients and those with free carnitine deficiency and that carnite treatment is not likely to benefit low- risk, asymptomatic patients or those with normal carnite levels. Expand
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TLDR
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