Urine Incontinence Induced by Valproic Acid

Excerpt

To the Editor: Being a broad spectrum antiepileptic drug (AED), Valproic acid (VPA) is one of the most common used AED in day-to-day practice. Urinary incontinence per se is rarely reported as a side-effect of VPA. We have observed four cases over the last two years of OPD practice (Table 1). Three patients had recurrent generalized tonic-clonic seizures (GTCS) with normal developmental milestones, clinical examination and MRI brain indicating benign epilepsy. One patient was found to have symptomatic focal epilepsy. These patients were started on VPA from the treating pediatricians. Within a span of few weeks to two months, they presented with nocturnal incontinence with or without day-time incontinence. VPA does were as per body weight (15–33 mg/kg/d); however serum levels were not monitored. There was no reported fever or burning micturition and routine blood and urine tests were normal. Subsequent to discontinuation of therapy with VPA, there was no urinary incontinence. …