Safety and efficacy of intravenous valproate in pediatric status epilepticus and acute repetitive seizures.
OBJECTIVE
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 microg/ml (mean +/- SD = 88 +/- 21.5 microg/ml).


CONCLUSIONS
Intravenous VPA loading is safe and effective for treating acute seizure emergencies in children.
Yu
Kian-Ti
KT
Harbor-UCLA Medical Center, 1000 W. Carson, Box 468, Torrance, CA 90502, USA. kyu@rei.edu
Mills
Sandra
S
Thompson
Nanora
N
Cunanan
Cedric
C
D000208:Acute Disease; D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D012640:Seizures / Q000188:drug therapy*; D013226:Status Epilepticus / Q000188:drug therapy*; D016896:Treatment Outcome; D014635:Valproic Acid / Q000008:administration & dosage* / Q000009:adverse effects
D000927:Anticonvulsants; D014635:Valproic Acid