title: Clinical experience with intravenous valproate as first-line treatment of status epilepticus and seizure clusters in selected populations.
abstract: OBJECTIVE
  The aim of this study was to evaluate the efficacy and safety of intravenous valproate (i.v. VPA) as first-line treatment of status epilepticus (SE) and seizure clusters in selected patient populations.
  
  
  METHODS
  We enrolled 23 patients (11 females and 12 males; mean age: 61 years) with SE who received i.v. VPA as first-line therapy (25 mg/kg in 100 mL saline infused over 15 min). ECG tracing was monitored before, during, and after infusion. Liver function and serum ammonia tests were conducted after 24 and 72 h of treatment. We evaluate the response of SE to i.v. therapy and short-term outcome.
  
  
  RESULTS
  In 15 out of 23 patients (65%), i.v. VPA was effective. In our population, we retrospectively identified three different subgroups: patients with cardiorespiratory comorbidities discouraging the use of traditional SE first-line drugs, patients with specific epileptic subsyndromes (such as idiopathic generalized epilepsy), and patients affected by psycho-organic syndromes. No significant adverse effects were detected.
  
  
  CONCLUSIONS
  Our study shows the clinical relevance of i.v. VPA as first-line therapy of SE in patients with medical conditions contraindicating the use of traditional first-line antiepileptic drugs for SE, and in those presenting with specific forms of SE.
authors.affiliation: 1Neurology Unit, Department of Neuroscience, "Sapienza" University of Rome, Rome, Italy.
authors.forename: Leonardo
authors.initials: L
authors.lastname: Lapenta
authors.forename: Alessandra
authors.initials: A
authors.lastname: Morano
authors.forename: Sara
authors.initials: S
authors.lastname: Casciato
authors.forename: Martina
authors.initials: M
authors.lastname: Fanella
authors.forename: Jinane
authors.initials: J
authors.lastname: Fattouch
authors.forename: Anna Elisabetta
authors.initials: AE
authors.lastname: Vaudano
authors.forename: Bruno
authors.initials: B
authors.lastname: Gregori
authors.forename: Nicola
authors.initials: N
authors.lastname: Vanacore
authors.forename: Mario
authors.initials: M
authors.lastname: Manfredi
authors.forename: Anna Teresa
authors.initials: AT
authors.lastname: Giallonardo
authors.forename: Carlo
authors.initials: C
authors.lastname: Di Bonaventura
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000927:Anticonvulsants / Q000008:administration & dosage*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007275:Injections, Intravenous; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy*; D013226:Status Epilepticus / Q000188:drug therapy*; D016896:Treatment Outcome; D014635:Valproic Acid / Q000008:administration & dosage*; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid