Skip to main content Skip to main navigation menu Skip to site footer

Administering Valproic acid in epilepsy and speech delay in children

  • Vinia Rusli ,
  • Irwanto ,


Background: Epilepsy is a recurrent seizure without a trigger. Epilepsy is a chronic disease that is often found in children. Valproic acid is an Anti-Epileptic Drug (AED) often given to children. The effect of valproic acid administration on speech delay has rarely been reported. This case study aims to evaluate the effect of administering valproic acid on epilepsy and speech delay in children

Case Description: A 3-year-old girl was referred to Dr. Soetomo Hospital with epilepsy and speech delay. The patient had recurrent unprovoked seizures since the age of 2 years. She had received valproic acid therapy at the previous hospital and was seizure-free for 5 months before being referred to DSH. The girl can speak in one word but lacks two-word meaningful phrases. There was no perinatal history or previous serious illness. Physical examination was within normal limits. The Denver II examination result was suspect because she failed in speech and language. Her hearing test was normal. Valproic acid was then replaced with phenytoin. In follow-up 7 months after the AED was changed to phenytoin, the patient could string words and speak in sentences. A repeat Denver exam reveals normal speech and language aspects.

Conclusion: Giving valproic acid to patients with epilepsy may trigger speech delay in children.


  1. Anderson M, Egunsola O, Cherrill J, Millward C, Fakis A, Choonara I. A prospective study of adverse drug reactions to antiepileptic drugs in children. BMJ Open. 2015;5(6):e008298.
  2. Baumer FM, Cardon AL, Porter BE. Language Dysfunction in Pediatric Epilepsy. J Pediatr. 2018;194:13-21.
  3. Anggraini ND, Gunawan PI, Saharso D, Irwanto. A comparison of glutamic acid decarboxylase serum autoantibody levels in pediatric intractable and non-intractable epilepsy. Medicina Clínica Práctica. 2021;4:100237
  4. Andrianti PT, Gunawan PI, Hoesin F. Profil Epilepsi Anak dan Keberhasilan Pengobatannya di RSUD Dr. Soetomo Tahun 2013. Sari Pediatri. 2016;18(1):34-39.
  5. Doo JW, Kim SC, Kim SJ. Influence of valproate on language functions in children with epilepsy. Epilepsy Behav. 2018;78:68–72.
  6. Chanda S, Ang CE, Lee QY, Ghebrial M, Haag D, Shibuya Y, et al. Direct Reprogramming of Human Neurons Identifies MARCKSL1 as a Pathogenic Mediator of Valproic Acid-Induced Teratogenicity. Cell Stem Cell. 2019;25(1):103-119.
  7. Christensen J, Grønborg TK, Sørensen MJ, Schendel D, Parner ET, Pedersen LH, et al. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism. JAMA. 2013;309(16):1696-1703.
  8. Montanari S, Mayr R, Subrahmanyam K. Bilingual Speech Sound Development During the Preschool Years: The Role of Language Proficiency and Cross-Linguistic Relatedness. J Speech Lang Hear Res. 2018;61(10):2467-2486. doi:10.1044/2018_JSLHR-S-17-0393
  9. Feldman HM. How young children learn language and speech. Pediatr Rev. 2019;40(8):398-411.
  10. Scharf RJ, Scharf GJ, Stroustrup A. Developmental Milestones. Pediatr Rev. 2016;37(1):25-37.
  11. Sunderajan T, Kanhere SV. Speech and language delay in children: Prevalence and risk factors. J Family Med Prim Care. 2019;8(5):1642-1646.
  12. Irwanto, Ismail C, Moestakim MRD. Micronutrient characteristic in recurrent seizure in medicine controlled epileptic children with normal nutritional status. Acta Neurol Taiwan 2021;30(2):54-62.
  13. Smith V, Brown N. Prenatal valproate exposure and risk of autism spectrum disorders and childhood autism. Arch Dis Child Educ Pract Ed. 2014;99(5):198
  14. Liu H, Tan M, Cheng B, Wang S, Xiao L, Zhu J, et al. Valproic Acid Induces Autism-Like Synaptic and Behavioral Deficits by Disrupting Histone Acetylation of Prefrontal Cortex ALDH1A1 in Rats. Frontiers in Neuroscience. 2021;15:641284.
  15. Islamiyah WR, Nasronudin, Machin A, Ernawati I, Sugianto P. Relationship between CYP2C19 polymorphisms and weight gain in epilepsy patients treated with divalproex sodium: does gender matter?. Bali Medical Journal. 2022;11(3):1800-1804.
  16. Meidiary AAA, Gelgel AM, Putra IGNP. Electroencephalogram (EEG) features and clinical presentation in the elderly patient at neurologic policlinic Sanglah General Hospital between July 2015-2017 period. Bali Medical Journal. 2019;8(2):576-580.
  17. Lestari ND, Rizkidawati, Shafira CP, Suherman, Mutiawati E. Factors affecting the mini-mental state examination (MMSE) score in the epilepsy patients in Aceh, Indonesia. Bali Medical Journal. 2020;9(1):185-188.

How to Cite

Rusli, V., & Irwanto. (2023). Administering Valproic acid in epilepsy and speech delay in children. Bali Medical Journal, 12(3), 2601–2603.