ArticleCureus2025
Massive Valproic Acid Overdose With Confirmed Pharmacobezoar Formation and Neuromuscular Toxicity: A Case Report and Literature Review.
Article in Cureus, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
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Who cites it
3 citing papers in PubMed.
- Protective Effect of L-Arginine and Filgrastim Against Valproic Acid-Induced Histopathological Changes on the Gastric and Lingual Mucosa.Journal of applied toxicology : JAT · 2026Article
- Expanded Hemodialysis Using a Medium Cut-Off Dialyzer for Severe Valproic Acid Poisoning: A Case Report with Real-Time Therapeutic Drug Monitoring.Journal of clinical medicine · 2026Article
- Case Report: Massive sustained-release valproate overdose with prolonged gastric tablet retention and partial pharmacobezoar formation managed by endoscopic removal and delayed extracorporeal therapy.Frontiers in pharmacology · 2026Article
Corrections and comments
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Authors and funding
4 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
We present a 42-year-old man who arrived obtunded to our emergency department (ED) after ingesting 60 g of extended-release valproic acid (VPA). Imaging and endoscopy confirmed a pharmacobezoar, a rare complication of overdose.The patient was managed with early airway protection, gastrointestinal (GI) decontamination, intravenous (IV) levocarnitine (L-carnitine), naloxone, and continuous renal replacement therapy (CRRT). His initial hospital course was stable but later complicated by delayed neuromuscular toxicity with extrapyramidal symptoms (EPS) requiring inpatient rehabilitation and multidisciplinary follow-up. This case highlights the clinical challenge of massive VPA overdose complicated by pharmacobezoar formation and delayed neuromuscular sequelae. Early risk assessment led to recognition and aggressive treatment of a potentially life-threatening ingestion in which airway protection, serial monitoring, endoscopic confirmation, and extracorporeal elimination were crucial to a favorable outcome. This case underscores the need for vigilance in severe VPA ingestions and reinforces the role of advanced diagnostic and therapeutic strategies in preventing further deterioration.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.