Waddling Gait: A complication of valproate therapy and a thought beyond vitamin D deficiency
Journal Title: Sultan Qaboos University Medical Journal - Year 2020, Vol 20, Issue 1
Abstract
Proximal muscle weakness is a common presentation in paediatric-orthopaedic clinics and is frequently paired with a vitamin D deficiency diagnosis. Recently, side effects of the extensive use of antiepileptic and antipsychotic drugs such as sodium valproate in childhood disorders are being documented. Sodium valproate causes a time-dependent, drug-induced proximal myopathy. We report a 13-year-old female patient who presented at the Orthopaedic Outpatient Department at Lady Hardinge Medical College, New Delhi, India, in 2019 with an abnormal gait. The patient was taking a combination therapy of sodium valproate, risperidone and trihexyphenidyl for absence seizures and a mood disorder. Following clinical investigations, the patient was diagnosed with proximal myopathy. As a result of elevated serum alkaline phosphatase and creatine kinase myocardial band levels, sodium valproate was replaced with ethosuximide and a carnitine supplementation was prescribed. The patient fully recovered and regained full mobility. Proximal myopathy had been incorrectly managed and assumed to be caused by a vitamin D deficiency.
Authors and Affiliations
Amit Sharma, Siddhartha Sinha, Amit Narang, Dushyant K. Chouhan, Sumit Gupta
Keywords
Related Articles
- EP ID EP678543
- DOI -
- Views 234
- Downloads 0
Lead Toxicity due to Ingestion of Lead-Contaminated Opium in a Patient Presenting with Motor Neuropathy and Upper Limb Paresis: A case report
Opium users may present with central or peripheral nervous system-related symptoms, gastrointestinal complications and anaemia; in such cases, lead poisoning should be suspected and chelation therapy initiated as soon as...
Acute Coronary Syndrome, Diabetes and Hypertension Oman must pay more attention to chronic non-communicable diseases
Attitudes of Non-Asthmatic Children Towards Their Asthmatic Peers Influence of interactions with asthmatic relatives and peers
Objectives: Tis study aimed to examine non-asthmatic children’s acceptance of and attitudes towards their asthmatic peers in Jordan. Methods: Tis descriptive cross-sectional study was conducted between September 2015 an...
Uremic Leontiasis Ossea
Tree-dimensional reconstructions of the (A) facial features and (B) bones of a 23-year-old female with uremic leontiasis ossea based on non-contrast sinus computed tomography of the (C) mandible and (D) maxilla.
Predicting the Pathogenic Potential of BRCA1 and BRCA2 Gene Variants Identifed in Clinical Genetic Testing
Objectives: Missense variants are very commonly detected when screening for mutations in the BRCA1 and BRCA2 genes. Pathogenic mutations in the BRCA1 and BRCA2 genes lead to an increased risk of developing breast, ovar...