Valproate induced nocturnal enuresis – a seldom side effect?

Aims: Valproate is an antiepileptic drug with a wide spectrum efficacy in the management of various types of seizures and epileptic syndromes. It still makes the first choice drug in many forms of paediatric epilepsy syndromes. Although many side effects of valproate are well known, there is still difficulty in recognising of nocturnal enuresis as seldom but possible side effect of this drug.

Methods: We describe six well documented cases of secondary nocturnal enuresis as a sole side effect owing to valproate therapy. All children (5 boys and 1 girl) had known epilepsy; idiopathic generalised epilepsy (4) and cryptogenic focal epilepsy (2) respectively. All but two of the children took valproate as monotherapy when manifesting this problem. The average dosage of valproate amounted 650mg/d. Enuresis embraced in three cases a comprehensive psychological and urological examination and treatment.

Results: After sodium valproate was discontinued in the clinical setting, the symptoms disappeared in all patients.

Conclusion: The nocturnal enuresis can lead to substantial functional impairment in everyday life and can be very irksome for the patient and his family. The purpose of this work is to highlight the possible side effects of this drug that all clinicians should be aware of when using it as an antiepileptic agent, particularly as there are still very few literature on this problem.

Epilepsy - Valproate - Children - Nocturnal enuresis