The Frequency of Reversible Parkinsonism and Cognitive Decline Associated with Valproate Treatment: A Study of 364 Patients with Different Types of Epilepsy


Address correspondence and reprint requests to Dr. D. Sokić at Institute of Neurology, CCS, Dr. Subotica 6, 11000 Belgrade, Serbia. E-mail: dsokic@sezampro.yu


Summary: Purpose: We report the frequency of parkinsonism and cognitive decline (P/CD) in patients treated with valproate (VPA) after 1 year of treatment and at least 1 year of follow-up.

Methods: Three hundred sixty-four patients with various epileptic syndromes and seizure types were treated with VPA mono- or polytherapy for more than 1 year.

Results: We found five cases of P/CD (1.37%; 95% CI, 0.18–2.56%). Among 140 patients with different adverse effects (AEs) of VPA, P/CD were among the rarest in frequency but significant in terms of drug discontinuation (five of 17).

Conclusions: Early identification of this type of AE and discontinuation of the drug led to complete recovery in affected patients.