ORIGINAL ARTICLE   

Gazzetta Medica Italiana - Archivio per le Scienze Mediche 2021 October;180(10):557-61

DOI: 10.23736/S0393-3660.20.04536-2

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Side effects of valproic acid: daytime incontinence and nocturnal enuresis

Emel ISIYEL ¹ ✉, Adem Y. KOKSOY ¹, Seyda KOSE ², Esra GURKAS ³, Bilge KARABULUT ⁴, Umut S. BAYRAKCI ¹

¹ Department of Pediatric Nephrology, University of Health Sciences Ankara Child Health and Disease, Hematology, Oncology Training and Research Hospital, Ankara, Turkey; ² Department of Pediatrics, University of Health Sciences Ankara Child Health and Disease, Hematology, Oncology Training and Research Hospital, Ankara, Turkey; ³ Department of Pediatric Neurology, University of Health Sciences Ankara Child Health and Disease, Hematology, Oncology Training and Research Hospital, Ankara, Turkey; ⁴ Department of Pediatric Urology, University of Health Sciences Ankara Child Health and Disease, Hematology, Oncology Training and Research Hospital, Ankara, Turkey

BACKGROUND: Valproic acid is one of the most common antiepileptic drugs administered for epilepsy in children. It has a lot of adverse effects, and nocturnal enuresis is one of them. An association between the incontinence/nocturnal enuresis and valproate is not well defined in the literature. We aimed to investigate the results of uroflowmetry in VPA administered children who had nocturnal and/or diurnal incontinence.
METHODS: Twenty-one patients were included in the study who were followed up with the diagnosis of epilepsy and who had nocturnal enuresis and/or nocturnal enuresis and daytime incontinence with increased micturition after the initiation of VPA. Incontinence symptoms scores and results of uroflowmetry were recorded for each patient as well as detailed physical examination, laboratory and radiologic investigations
RESULTS: After the initiation of VPA; 16 patients had only enuresis, five patients had enuresis and day-time incontinence with increased frequency of micturition. Except for one patient with staccato pattern, uroflowmetry results were normal in all 20 patients. No significant difference was found between patients who had only nocturnal incontinence and those who had both nocturnal and daytime incontinence in terms of uroflowmetry results.
CONCLUSIONS: Enuresis and daytime incontinence are a distressful problem both for children and parents, so families should be questioned about the presence of enuresis and/or day-time incontinence before the initiation of the VPA treatment.

KEY WORDS: Valproic acid; Urinary incontinence; Enuresis