[Intravenous valproic acid administration in status epilepticus]

Abstract

Despite progress in controlling status epilepticus (SE), a search is still in progress for a drug--a single agent--that would successfully and safely interrupt this life-threatening situation. Valproate (VPA) has been used in control of SE since the 1970s, yet only in the late 1980s was VPA first administered intravenously, with good results. Twenty adult patients in acute or static SE with generalized tonic-clonic seizures (GTCS) or simple partial motor seizures were administered VPA (Depakine Injectable 400 mg, Sanofi Winthrop) in a bolus dose of 15 mg/kg body weight and then 30 min later as a continuous infusion of 1 mg/kg/h for 24 h. The therapeutic effect was evaluated depending on the type of SE, its aetiology and the time lapse between seizure onset and drug administration. Response latency time (time between drug administration and seizure cessation) was considered as index of therapy success. SE was interrupted in < 30 min in 80% of cases (88.8% of patients with GTCS and 72.7% of those with partial simple motor seizures). A better effect was achieved in patients with static SE and in patients in whom SE lasted < 3 h before treatment. In 60% of patients with interrupted SE, the response latency time was < 20 min. The results indicate high success of VPA in SE control.