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Epilepsy — RACP Paediatrics MCQ

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ModerateNeurology & DevelopmentEpilepsyRACP Paediatrics

A 4-year-old child with established epilepsy is on sodium valproate. His mother asks about side effects to monitor. Which of the following is the most important long-term concern with sodium valproate in children?

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Correct answer: A — Hepatotoxicity, particularly in children under 2 years on polytherapy

Sodium valproate carries a risk of fatal hepatotoxicity, particularly in children under 2 years of age on polytherapy, and those with metabolic disorders (especially mitochondrial disease). Regular monitoring of liver function is recommended. Other important side effects include weight gain, tremor, alopecia, thrombocytopenia, and teratogenicity (critical in female adolescents).

Reference: AMH Children's Dosing Companion – 2024 – Sodium Valproate