Effects of divalproex sodium on hemoglobin level.

A small number of molecular and clinical studies found an association between increases in fetal hemoglobin concentration and valproate (VPA) use. However, the effect of VPA on total hemoglobin (Hb) level has not been studied. We herein review a randomized, double-blind, parallel group, multicenter, concentration-response design trial that compared the safety and efficacy of target trough plasma VPA concentrations in patients with complex partial seizures treated with divalproex sodium as monotherapy. Trough VPA concentrations and concomitant Hb levels that were drawn at baseline and intermittently throughout a 24-week period were analyzed. A total of 549 trough plasma VPA levels and concomitant total Hb levels were analyzed. Correlation between all study variables (gender, age, trough plasma VPA level, duration of exposure, baseline Hb level) and change in total Hb level showed that only baseline Hb level was a significant factor (inverse relationship). Hb increase was evident in 47.0% of values. A clinically relevant increase in Hb (>0.5 g/dL) occurred in 23.9% of values. VPA is associated with a change in total Hb level that correlates inversely with baseline Hb levels.

Unilateral Mu Rhythm and Associated Cortical Lesions on Brain MRI.

PURPOSE: The purpose of this study was to assess the frequency of occurrence of a unilateral mu rhythm and the associated neuroimaging findings on dedicated epilepsy protocol brain MRI. METHODS: We retrospectively reviewed the EEG reports database at the American University of Beirut Medical Center between 2011 and 2014 searching for the presence of a unilateral mu rhythm. For patients with a unilateral mu rhythm, we recorded the patients' demographics, number of EEGs performed, characteristics of the mu activity, and the findings on the epilepsy protocol brain MRIs. RESULTS: A total of 7986 patients underwent 9,509 EEG between 2011 and 2014. Four patients (0.05%) aged between 19 and 55 years had evidence of a unilateral mu rhythm. Three patients were diagnosed with localization-related epilepsy and one with syncope. The brain MRIs showed cortical lesions involving the parietal cortex, ipsilateral to the unilateral mu rhythm in the three patients with epilepsy. CONCLUSIONS: A unilateral mu rhythm is a rare phenomenon on the scalp EEG that should prompt a search for an ipsilateral lesion, even in the absence of additional EEG abnormalities.