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In turn, the impairment in -oxidation can shift the metabolism of VPA toward predominantly peroxisomal -oxidation, resulting in excessive production and accumulation of -oxidation products, including 4-en-VPA a metabolite that is incriminated in VPA-induced hepatotoxicity

Neul and colleagues provided revised diagnostic criteria for Rett syndrome and emphasized that it remains a clinical diagnosis because not all patients with Rett syndrome have MECP2 mutations and not all patients with MECP2 mutations have Rett syndrome (188)

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Prospective controlled multicenter study of loper amide in pregnancy