title: Low-dose sodium valproate in the treatment of idiopathic generalized epilepsies.
abstract: OBJECTIVE
  Most patients with idiopathic generalized epilepsies (IGEs) have good seizure control when on antiepileptic drugs. To analyze prospectively the response to low-dose sodium valproate (VPA) treatment (<1000 mg/day) together with plasma VPA levels in a cohort of patients with IGE.
  
  
  METHODS
  Patients with IGE were selected and followed for almost 2 years. In patients on VPA with no seizures in the last year, VPA dose was lowered to <1000 mg/day. Newly diagnosed patients with IGE started treatment on VPA directly on this low dose.
  
  
  RESULTS
  Fifty-four patients were included, with juvenile myoclonic epilepsy (JME) in 23 (42.6%), juvenile absence epilepsy (JAE) in 17 (31.5%), and generalized tonic-clonic seizures only (GTCS only) in 14 (25.9%). VPA at low dose was administered to 38 (70%) patients. Mean plasma VPA level was 44.21 mg/l (18-78; SD 15.18). Seizure relapse during the 2-year follow-up was observed in 8 (21%). A reduction in adverse events was observed (P < 0.048). The only factor related to efficacy of VPA at low dose was syndromic diagnosis. Low-dose VPA controlled 92.9% (13) of patients with GTCS only, 78.3% (18) of those with JME, and 29.5% (5) of those with JAE.
  
  
  CONCLUSIONS
  Low-dose VPA was a highly effective treatment for the majority of those with JME and GTCS only. The seizures in JAE tended to be more resistant to treatment, usually requiring higher doses of VPA or polytherapy.
authors.affiliation: Epilepsy Unit, Hospital Universitari de Bellvitge, Hospitalet de Llobregat, Spain; Cognition and Brain Plasticity Group, Bellvitge Biomedical Research Institute (IDIBELL), Hospitalet de Llobregat, Spain.
authors.forename: J
authors.initials: J
authors.lastname: Miró
authors.forename: M
authors.initials: M
authors.lastname: Aiguabella
authors.forename: M
authors.initials: M
authors.lastname: Veciana
authors.forename: R
authors.initials: R
authors.lastname: Juvany
authors.forename: M
authors.initials: M
authors.lastname: Santurino
authors.forename: E
authors.initials: E
authors.lastname: Leiva
authors.forename: J
authors.initials: J
authors.lastname: Salas-Puig
authors.forename: M
authors.initials: M
authors.lastname: Falip
mesh_terms: D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood; D004832:Epilepsy, Absence / Q000097:blood / Q000188:drug therapy; D004829:Epilepsy, Generalized / Q000097:blood / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D020190:Myoclonic Epilepsy, Juvenile / Q000097:blood / Q000188:drug therapy; D011446:Prospective Studies; D012640:Seizures / Q000097:blood / Q000188:drug therapy; D016896:Treatment Outcome; D014635:Valproic Acid / Q000008:administration & dosage* / Q000009:adverse effects / Q000097:blood
chemical_list: D000927:Anticonvulsants; D014635:Valproic Acid
keywords: absences; antiepileptic drugs; dose response; generalized tonic-clonic seizures; myoclonia; plasma levels