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Abnormal ¹³C-Fatty Acid Breath Tests in Patients Treated With Valproic Acid

Division ot Child Neurology, National Center Hospital for Mental, Nervous and Muscular Disorders, National Center of Neurology and Psychiatry, Kodaira, Department of Pediatrics, Toho University School of Medicine

Norio Sakuragawa, MD

Division ot Child Neurology, National Center Hospital for Mental, Nervous and Muscular Disorders, National Center of Neurology and Psychiatry, Kodaira

Makiko Suehiro, PhD

Department of Nuclear Medicine, Tokyo Metropolitan Geriatric Hospital

Hiroyuki Watanabe, BS

Eiken Immunochemical Laboratory Tokyo, Japan

Breath tests using fatty acids labeled with a stable isotope (carbon 13) were carried out on epileptic patients treated with valproic acid in order to detect abnormal fatty acid metabolism. The patients were given ¹³C-octanoic acid or ¹³C-palmitic acid orally, and expired air was collected at appropriate intervals for the analysis of ¹³CO₂ content by a mass spectrometer. Eight patients were tested in the palmitic acid breath test and nine patients in the octanoic acid breath test. Controls for these tests were patients treated with antiepileptic drugs other than valproic acid and unmedicated cerebral palsy patients. In the valproic acid-treated group, ¹³C recovery was reduced by 56% in seven hours on the ¹³C-palmitic acid breath test, while the octanoic acid breath test showed a 52% reduction in one hour. This suppression of fatty acid oxidation was significantly correlated with dose of valproic acid in both tests. No influence of other drugs was detected, and the effect of administered carnitine was not conclusive. This study demonstrates the usefulness of ¹³C-labeled fatty acid breath tests in clinical practice. (J Child Neurol 1988;3:250-257).

Journal of Child Neurology, Vol. 3, No. 4, 250-257 (1988)
DOI: 10.1177/088307388800300404


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