use of valproic acid in a case of post op Rt frontal lobe astrocytoma

[sam573]

i was diagnosed with right side frontal lobe tumor on MRI, about two and half year ago. the onset of the disease was sudden with convulsions without any previous sign or symptom. I was operated upon the second day of being diagnosed and the biopsy showed it was grade 2 astrocytoma, afterwards i was given about 30 sessions of radiotherapy. after my surgery I have been taking sodium valproate chrono 800 mgs total in a day for 2 years and 5 months. I was advised to undergo 3 MRIs in this period which were all normal, post op period there has not been any incident of any seizure also. I am 36 yrs old female and my question is that for how long do i need to continuewith valproate and what is manner in which it is stopped? I am fine otherwise but the only problem i am facing now is, I am not able to tolerate the drug now mainly because of weightgain, menstrual irregularities, edema most of the times, tendency for small cuts haemorrhages with slighest injury, constipation, distended abdomen n so on. Kindly help..

[Lama Chahine, MD]

Thanks for using the forum. I am happy to address your questions, and my answer will be based on the information you provided here. Please make sure you recognize that this forum is for educational purposes only, and it does not substitute for a formal office visit with your doctor.

Without the ability to examine you and obtain a history, I can not tell you what the exact cause of your symptoms is. However I will try to provide you with some useful information.

As you mention, valproic acid has various side effects, weight gain is a common one. Other antiepileptic medications do not cause weight gain, but each has its side effects, some are much more tolerable than others. While it is great news that your MRI has not shown any tumor recurrence, this does not necessarily imply that you are no longer at risk for seizures. Seizure risk after undergoing tumor surgery really depends on where the tumor was and how much scarring there was from the tumor and surgery, how many seizures you had initially (before or after the surgery, etc). Not everyone who has seizures due to a tumor has to be on life-long seizure medication. Stopping the medication, or switching to another one if the side effects of valproic acid are too great for you may all be options. I strongly recommend you see your neurologist for further recommendations regarding your seizure medication; referral to an epilepsy specialist may be an option too. The important thing is that the valproic acid should not be stopped suddenly but rather tapered over days to weeks based on a regimen prescribed by your neurologist.

Thank you for this opportunity to answer your questions, I hope you find the information I have provided useful, good luck.

[MaryMary5456]

My daughter has epilepsy. We were on Valproic for a couple of years. I felt the drug wasn't doing anything for my daughter but make her gain weight. The doctor started lowing her daily amounts. Every 3rd day or so it was a bit less until after a month and a half we were completely off of it. However, she has since had the ocassional seizure, which she never had before. Looking back, I now think the medication was keeping the seizures away but that had left my mind all together. The big concern was her weight gain. She is older now and she knows what triggers a seizure (brightness or lack of sleep) and can feel if one is coming and can keep it away with some relaxation technics she learned. We  have not returned to the Valproic. Don't know if this is helpful but good luck.

[sam573]

i will be grateful if i get some medical information by the experts in the forum, thanx a lot

[sam573]

Thanx dear, for your concern and best of luck for your daughters health, Regards

[sam573]

Thankyou Sir, for your time and the valuable information you gave. I am a medical graduate and i understand that you can not comment much without seeing the patient yourself or having dealt with the patient in the past but i want to know, if u can help me that how the amount of scarring in brain is judged? i hv i feel two episodes of the seizure which were at an interval of 15 minutes, and then i was hospitalised and treated. After dt by Gods grace i didnot have any seizure in the past 2 and half years, now the problem is that i am in a different country and although i am in constant touch with my neurosurgeon and he has seen all myMRIs and i last met him 6 months ago, and according to him i can now taper the dose over a period of 6 months, which i too want very desperately but at the same time i am worried that may be it is early to stop the drug as my doctor also knows that i am unhappy with this medicine. Thogh i hv full faith in him but am slightly confused, please help