Objective  To investigate the occurrence and clinical characteristics of the adverse reactions of hyperammonemic encephalopathy caused by sodium valproate and provide reference for the safe clinical use of the drug.

Methods  CNKI, WanFang Data, VIP, PubMed and Web of Science databases were electronically searched to collect case reports on valproate-induced hyperammonemic encephalopathy from the inception to March 2023. The extracted data was conducted for statistical analysis.

Results A total of 37 documents with 41 patients were finally included. Among them, 28 patients (68.3%) were males and 13 patients (31.7%) were females, aged 5 to 78 years, the median age was 41 years; most of the patients had no underlying diseases but the blood ammonia concentrations of them were abnormally high in laboratory tests, and the main clinical manifestations were neurological impairment such as cognitive impairment, drowsiness, coma and other disorders of consciousness. After drug discontinuation, drug switch and symptomatic treatment, they gradually recovered consciousness and the blood ammonia concentrations returned to normal.

Conclusion  It is not easy to recognize and detect the high blood ammonia encephalopathy caused by the application of sodium valproate in clinical practice, so the clinical performance and blood concentration of this drug should be closely monitored, and once the abnormalities are detected, patients should be treated symptomatically in time to ensure the safety of the drug use.

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