Abstract
Objective. Valproic acid (VPA) is used in epilepsy treatment and as a stabilizer in bipolar disorder for over 40 years. Extremely rarely it can cause symptoms of Parkinsonism of unknown mechanism.
Case. We present the 76-year old male with symptomatic epilepsy treated with VPA, who developed severe extrapyramidal syndrome in a form of bradykinesia and hypertonia of upper and lower extremities within 2 days after an increase of a dose of VPA. CT scan excluded acute ischemic and haemorrhagic lesions. The level of VPA in plasma was in the reference range. Decreasing a dose of VPA caused improvement in motor functions and better gait. The symptoms withdrew completely within the following 3 months.
Discussion. It is important to consider side effects of VPA, when patients develop Parkinsonian syndrome during therapy. Discontinuation of the drug usually results in reduction in the Parkinsonian symptoms or its complete remission.