2026 Clinician Corner - Acute hypothermia induced by valproic acid

CE BROKER: For Texas physicians who have updated their EthosCE profile, credit claimed for this activity will be reported to CE Broker.

Abstract 

This case report details an incident of acute hypothermia following the administration of valproic acid in a patient presenting with seizures. We describe the clinical presentation, diagnostic workup, treatment plan, and potential mechanisms underlying this rare adverse effect.

Keywords:  Adverse effect; hypothermia; valproic acid

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Faculty credentials/disclosure 

Harshith Dasara, BSca, Bradley Conn, BSca, and Sadat Shamim, MDb

a Naresh K. Vashisht College of Medicine, Texas A&M University, Bryan, Texas, USA

b Department of Neurology, Baylor University Medical Center, Dallas, Texas, USA

Corresponding author: Sadat Shamim, MD, 3434 Swiss Avenue, Ste. 400, Dallas, TX 75246 (e-mail: [email protected])

ORCID Sadat Shamim iD http://orcid.org/0009-0004-4091-6969

The planners and faculty for this activity have no relevant financial relationships to disclose. The authors report no funding. The patient consented to publication of this case report.

Corresponding author: Austin T. Jones, MD, 4310 James Casey St., Building 3, Austin, TX 78745 (e-mail: [email protected])

ORCID Austin T Jones: https://orcid.org/0009-0008-4733-1946

The planners and faculty for this activity have no relevant financial relationships to disclose. The authors report no funding. The patient consented to publication of this case report.

Process

Click the "add to cart/begin" button, pay any relevant fee, take the quiz, complete the evaluation, and claim your CME credit.  You must achieve 100% on the quiz with unlimited attempts available.

  • By completing this process, you are attesting that you have read the journal article.

Expiration date:

Credit eligibility for this article is set to expire on September 1, 2027.

Learning Objectives

After completing the article, the learner should be able to:

  • Acknowledge valproic acid’s underappreciated adverse effect of hypothermia and its possible mechanism via gamma-aminobutyric acid.
  • Apply this knowledge when prescribing valproic acid in an inpatient setting to possibly prevent unnecessary repeated sepsis workup.
  • Apply this knowledge to help avoid complications in an outpatient setting when prescribing valproic acid.

Key Points 

  • Documented repeated episodes of hypothermia occurred shortly after valproic acid administration, supporting an association between the drug and reduced body temperature.
  • The mechanism by which valproic acid causes hypothermia is not yet fully understood, but evidence points to its ability to increase gamma-aminobutyric acid.
  • Awareness of this underappreciated adverse effect can help avoid complications in an outpatient setting and prevent repeated sepsis workup in an inpatient setting.

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Course summary

Available credit: 
  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • 1.00 American Board of Surgery (ABS) Accredited CME

    Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

  • 1.00 AMA PRA Category 1 Credit™
    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 1.00 Attendance
Course opens: 
09/01/2026
Course expires: 
09/01/2027
Cost:
$25.00

Harshith Dasara, BSca, Bradley Conn, BSca, and Sadat Shamim, MDb

a Naresh K. Vashisht College of Medicine, Texas A&M University, Bryan, Texas, USA

b Department of Neurology, Baylor University Medical Center, Dallas, Texas, USA

Corresponding author: Sadat Shamim, MD, 3434 Swiss Avenue, Ste. 400, Dallas, TX 75246 (e-mail: [email protected])

ORCID Sadat Shamim iD http://orcid.org/0009-0004-4091-6969

The planners and faculty for this activity have no relevant financial relationships to disclose. The authors report no funding. The patient consented to publication of this case report.

Accreditation

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.

Designation

AMA PRA Category 1 Credit™

The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health designates this Journal-based CME activity for a maximum of 1.0 AMA PRA Category 1 Credit™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

ABS CC

Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

ABIM MOC

 Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.0 MOC points in the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

Available Credit

  • 1.00 American Board of Internal Medicine (ABIM) MOC Part 2

    Successful completion of this CME activity, which includes participation in the evaluation component, enables the participant to earn up to 1.00 MOC points in the American Board of Medicine’s (ABIM) Maintenance of Certification (MOC) program. It is the CME activity provider’s responsibility to submit participant completion information to ACCME for the purpose of granting ABIM MOC credit.

  • 1.00 American Board of Surgery (ABS) Accredited CME

    Successful completion of this CME activity enables the learner to earn credit toward the CME requirement of the American Board of Surgery’s Continuous Certification program. It is the CME activity provider's responsibility to submit learner completion information to ACCME for the purpose of granting ABS credit.

  • 1.00 AMA PRA Category 1 Credit™
    The A. Webb Roberts Center for Continuing Medical Education of Baylor Scott & White Health is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians.
  • 1.00 Attendance

Price

Cost:
$25.00
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