Clinical experience with intravenous valproate as first-line treatment of status epilepticus and seizure clusters in selected populations. (1st January 2014)

• Record Type: Journal Article
• Authors: Lapenta, Leonardo; Morano, Alessandra; Casciato, Sara; Fanella, Martina; Fattouch, Jinane; Vaudano, Anna Elisabetta; Gregori, Bruno; Vanacore, Nicola; Manfredi, Mario; Giallonardo, Anna Teresa; Di Bonaventura, Carlo
• Is Part Of: International journal of neuroscience. Volume 124:Number 1(2014:Jan.)
• Page Start: 30
• Page End: 36
• Publication Date: 2014-01-01
• Subjects: Nervous system -- Periodicals; 612.805
• DOI: 10.3109/00207454.2013.816957
• Languages: English
• ISSNs: 0020-7454

Abstract

<abstract> <title> <x xml:space="preserve">Abstract</x> </title> <p> <italic>Objective</italic>: The aim of this study was to evaluate the efficacy and safety of intravenous valproate (i.v. VPA) as first-line treatment of status epilepticus (SE) and seizure clusters in selected patient populations. <italic>Methods</italic>: We enrolled 23 patients (11 females and 12 males; mean age: 61 years) with SE who received i.v. VPA as first-line therapy (25 mg/kg in 100 mL saline infused over 15 min). ECG tracing was monitored before, during, and after infusion. Liver function and serum ammonia tests were conducted after 24 and 72 h of treatment. We evaluate the response of SE to i.v. therapy and short-term outcome. <italic>Results</italic>: In 15 out of 23 patients (65%), i.v. VPA was effective. In our population, we retrospectively identified three different subgroups: patients with cardiorespiratory comorbidities discouraging the use of traditional SE first-line drugs, patients with specific epileptic subsyndromes (such as idiopathic generalized epilepsy), and patients affected by psycho-organic syndromes. No significant adverse effects were detected. <italic>Discussion</italic>: Our study shows the clinical relevance of i.v. VPA as first-line therapy of SE in patients with medical conditions contraindicating the use of traditional first-line antiepileptic drugs for SE, and in those presenting with specific forms of SE.</p> </abstract>