Intravenous sodium valproate versus diazepam infusion for the control of refractory status epilepticus in children: a randomized controlled trial.
An open-label, randomized controlled study was conducted at a tertiary care teaching hospital to compare efficacy and safety of intravenous sodium valproate versus diazepam infusion for control of refractory status epilepticus. Forty children with refractory status epilepticus were randomized to receive either intravenous sodium valproate or diazepam infusion. Refractory status epilepticus was controlled in 80% of the valproate and 85% of the diazepam patients. The median time to control refractory status epilepticus was less in the valproate group (5 minutes) than the diazepam group (17 minutes; P < .001). None of the patients in the valproate group required ventilation or developed hypotension, whereas in the diazepam group 60% required ventilation and 50% developed hypotension after starting diazepam infusion. No adverse effects on liver functions were seen with valproate. It is concluded that intravenous sodium valproate is an effective alternative to diazepam infusion in controlling refractory status epilepticus in children and is free of respiratory depression and hypotension.
Mehta
Vishal
V
Department of Pediatrics, Advanced Pediatric Centre, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
Singhi
Pratibha
P
Singhi
Sunit
S
D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects; D002648:Child; D002675:Child, Preschool; D003975:Diazepam / Q000008:administration & dosage* / Q000009:adverse effects; D005260:Female; D006801:Humans; D007022:Hypotension / Q000139:chemically induced; D007223:Infant; D007262:Infusions, Intravenous; D008297:Male; D012121:Respiration, Artificial / Q000706:statistics & numerical data; D012131:Respiratory Insufficiency / Q000139:chemically induced / Q000628:therapy; D013226:Status Epilepticus / Q000188:drug therapy*; D013997:Time Factors; D016896:Treatment Outcome; D014635:Valproic Acid / Q000008:administration & dosage* / Q000009:adverse effects; D014662:Vasoconstrictor Agents / Q000627:therapeutic use
D000927:Anticonvulsants; D014662:Vasoconstrictor Agents; D014635:Valproic Acid; D003975:Diazepam