Intravenous valproate for seizures in 137 Taiwanese children - valproate naive and non-naive.
OBJECTIVE
Valproate has been widely used in controlling various kinds of seizures. Intravenous forms of valproate control seizures in a more rapid and efficacious pattern than oral forms. We evaluated the effectiveness and adverse effects of intravenous valproate for controlling seizures in Taiwanese children under 18 years old.


METHODS
Retrospective chart reviews were performed on 137 pediatric patients receiving valproate infusion from January 2003 to December 2006. Patients were divided into 4 groups as follows: (1) previous use of other antiepileptic drugs (AEDs) (n=59), (2) previous use of oral valproate (n=8), (3) previous use of other AEDs and valproate (n=32), (4) first time use of valproate (n=38). The indications for using intravenous valproate include status epilepticus, repetitive seizures, prophylactic use for brain operations or in cases where oral administration was not feasible due to medical problems.


RESULTS
The mean age was 8±6.22 years old and the average dose was 31.2±26.45 mg/kg/day. The mean duration of usage was 7.8±6.99 days. Eight patients failed to respond to intravenous valproate and the AED was shifted to other drugs. Thirty-two patients achieved successful seizure control after adding other AEDs following intravenous valproate. The seizure control rate in our study was 71%, and six patients died of complications associated with an underlying disorder. An allergic reaction (skin rash) was found in 1 patient, while no serious adverse effects were noted in our patients.


CONCLUSIONS
Intravenous valproate is effective and safe in controlling seizures in children who are either valproate naive or not.
Chang
Yu-Ching
YC
Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Lin
Jainn-Jim
JJ
Wang
Huei-Shyong
HS
Chou
Min-Liang
ML
Hung
Po-Cheng
PC
Hsieh
Meng-Ying
MY
D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D007275:Injections, Intravenous; D008297:Male; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy*; D014635:Valproic Acid / Q000008:administration & dosage*
D000927:Anticonvulsants; D014635:Valproic Acid