Safety and Efficacy of Intravenous Valproate in Pediatric Status Epilepticus and Acute Repetitive Seizures

Purpose: To evaluate the safety and efficacy of intravenous valproate (VPA) loading in children with status epilepticus (SE) or acute repetitive seizures. Methods: Retrospective review was performed on 40 pediatric patients with intravenous VPA loading. Patients were classified into two groups: SE (...

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Bibliographic Details
Published in:	Epilepsia (Copenhagen) Vol. 44; no. 5; pp. 724 - 726
Main Authors:	Yu, Kian‐Ti, Mills, Sandra, Thompson, Nanora, Cunanan, Cedric
Format:	Journal Article
Language:	English
Published:	Boston, MA, USA Blackwell Science Inc 01-05-2003 Blackwell
Subjects:	Acute Disease Acute repetitive seizures Acute seizure Adolescent Anticonvulsants - administration & dosage Anticonvulsants - adverse effects Anticonvulsants. Antiepileptics. Antiparkinson agents Biological and medical sciences Child Child, Preschool Dose-Response Relationship, Drug Drug Administration Schedule Emergencies Epilepsy - drug therapy Female Humans Infant Infusions, Intravenous Intravenous valproate Male Medical sciences Neuropharmacology Pediatric Pharmacology. Drug treatments Seizures - drug therapy Status epilepticus Status Epilepticus - drug therapy Treatment Outcome Valproic Acid - administration & dosage Valproic Acid - adverse effects Prognosis Intravenous administration Toxicity Epilepsy Anticonvulsant Intravenous valproate-Pediatric-Status epilepticus-Acute repetitive seizures-Acute seizure-Emergencies Neurological disorder Child Status epilepticus Repetition Human Nervous system diseases 4-Aminobutyrate transaminase Enzyme Transferases Enzyme inhibitor Valproic acid Cerebral disorder Chemotherapy Treatment Convulsion Transaminases Central nervous system disease Pharmacokinetics Therapeutic protocol
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Summary:	Purpose: To evaluate the safety and efficacy of intravenous valproate (VPA) loading in children with status epilepticus (SE) or acute repetitive seizures. Methods: Retrospective review was performed on 40 pediatric patients with intravenous VPA loading. Patients were classified into two groups: SE (n = 18) and acute repetitive seizures (n = 22). Thirty‐one patients were VPA naïve and received a full loading dose of 25 mg/kg; nine had subtherapeutic plasma VPA levels and received a partial loading dose. Average infusion rate was 2.8 mg/kg/min. Heart rate and blood pressure were measured before, during, and after infusion. Results: Intravenous VPA loading stopped seizures in 18 patients with SE within 20 min. All 18 patients regained baseline mental status within 1 h of seizure cessation. Among 22 patients with acute repetitive seizures, only one had further seizures after VPA infusion. One patient in the SE group complained of transient tremors. No significant changes in blood pressure or heart rate were found in either group. Postinfusion plasma VPA levels ranged from 51 to 138 μg/ml (mean ± SD = 88 ± 21.5 μg/ml). Conclusions: Intravenous VPA loading is safe and effective for treating acute seizure emergencies in children.
ISSN:	0013-9580 1528-1167
DOI:	10.1046/j.1528-1157.2003.41302.x