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Stopping treatment entirely (because B12, MMA or homocysteine values are back to standard) without the causes having been removed is not the correct way of treating a patient

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Bhles et al8 investigated the effects of carnitine supplementation in 15 (14 hyperammonemic) children with epilepsy treated with VPA monotherapy, and found that the prolonged L-carnitine supplementation was associated with normalization in plasma NH3 concentrations and marked increase in carnitine concentration in all patients with the significant correlations between the plasma NH3 concentrations and the AC/FC ratio