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The brain is a highly energy-demanding organ and requires bioenergetics adaptability to balance normal activity with pathophysiologic fueling of spontaneous recurrent seizures, the hallmark feature of the epilepsies

In patients who develop unexplained lethargy and vomiting or changes in mental status, hyperammonemic encephalopathy should be considered and an ammonia level measured

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and the treatment costs were $2350457, $2455434, $1348411, and $2684334, respectively

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