Lamotrigine-Associated Progressive Dysphasia and Cognitive Dysfunction.

Lamotrigine is generally accepted as a well-tolerated medication with few cognitive side effects. Here, we report a case of a 62-year old female with a severe, rapidly progressive dementia-like process which was completely reversed after reduction of lamotrigine. Associated findings included hyperreflexia with clonus, ataxia, Wernicke-like dysphasia, global cognitive impairment, burst suppression on electroencephalogram (EEG), and bilateral parietal hypo-metabolism on fluorodeoxyglucose-Positron Emission Tomography (FDG-PET).

Executive function predictors of delayed memory deficits after mild traumatic brain injury.

Delayed memory deficits are common for patients with mild traumatic brain injury (mTBI), according to a recent systematic review of meta-analyses (Karr et al., 2014). However, there has been little work to identify different cognitive processes that may be underpinning these delayed memory deficits for mTBI.

ERPs predict symptomatic distress and recovery in sub-acute mild traumatic brain injury.

Mild traumatic brain injury (mTBI) can affect high-level executive functioning long after somatic symptoms resolve. We tested if simple EEG responses within an oddball paradigm could capture variance relevant to this clinical problem. The P3a and P3b components reflect bottom-up and top-down processes driving engagement with exogenous stimuli.

Valproate serum concentrations in patients with hypoalbuminemia and medical complications.

Introduction: Valproic acid (VPA) and its derivatives are highly protein bound with free fraction increasing with dose and serum concentration. Consensus guidelines regarding dose adjustment for hypoalbuminemia are not available.

Methods: A literature search was performed using PubMed to identify articles with the following key terms: "valproate," "valproic acid," "protein binding," "albumin," and "hypoalbuminemia.

Enteral administration of protein supplement and valproate: A potential pharmacokinetic interaction.

Background: Valproic acid (VPA) and its derivatives are highly protein bound. Certain highly protein bound medications (eg, phenytoin) have specific administration instructions for patients on enteral nutrition supplements to optimize absorption of the medication. Pharmacokinetic interactions between VPA and enteral nutrition or protein supplements demonstrating impaired absorption have not been published to date.