THE ROLE OF INTRAVENOUS
VALPROIC ACID IN CHILDREN WITH INTRACTABLE STATUS EPILEPTICUSTHE ROLE OF
INTRAVENOUS VALPROIC ACID IN CHILDREN WITH INTRACTABLE STATUS EPILEPTICUS
Zhong Jianmin, Cai LY,
Zhou MZ
Jiangxi Children's
Hospital, Nanchang, China
Objective: To investigate the
efficacy of intravenous valproic acid (VPA) treatment of chidhood status
epilepticus (SE).
Methods: Fifty-two children with
SE unresponsive to benzodiazepines (including diazepam,clonazepam or
midazolam), phenobarbital, chloral hydrate, who received intravenous
VPA-The initial dose of 15mg/kg by bolus of 3 to 5 minutes followed by
maintenance infusions of 1~2mg/kg.h for 12~24 hours, were observed. Among
the 52 patients, they were 40 boys and 12 girls; mean age was 3 years 8
months (ranging from 4 months to 13 years); and 77.0%(40/52) of cases were
under 3 years of age. The seizures were generalized in 42 cases, partial
secondarily in 10. The etiology was as follow:infection(22), cryptogenic
epilepsy(20), cerebral palsy(4), toxicopathy(4), undetermined(2).
Results: In the 52 patients with
intractable seizures, 61.5% (32/52) of cases were treated successfully
without severe side effects by intravenous VPA administration-complete
seizure control in 42.3% (22/52) of all the patients within 30 minutes,
19.2% (10/52) within 24 hours. And there was seizure improvement (more than
50% reduction of seizures) in 19.2%(10/52) of cases. The remaining
19.2%(10/52) of patients showed no effects. Success did not appear to be
influenced by the seizure type.
Conclusions: Intravenous VPA were an
effective and safe agent to control refractory seizures in children with
SE, especially in seizures unresponsive to phenobarbital and
benzodiazzepines.