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Borbath and coworkers [82] reported the case of a 51-year-old woman who received 10 mg/kg VPA daily to prevent seizures after a neurosurgical procedure, and who developed VHE (ammonia concentration 234 mol/l) without any sign of hepatic dysfunction

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Prophylactic use of carnitine in such situations has been shown to reduce the endothelial damage caused by lipopolysaccharide (LPS) and TNF-

However, because of their low plasma and brain concentrations, it is unlikely that they contribute significantly to the anticonvulsant effects of VPA [10]