REVIEW – December 2009

The role of intravenous valproate sodium in the treatment of status epilepticus

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Abstract

Emergency treatment of seizures is an important practical issue, in particular, therapy of status epilepticus. The aim of the study was to evaluate the role of intravenous valproate sodium (IV VPA) in the treatment of status epilepticus (SE). A loading dose of IV valproate can be administered safely and rapidly. VPA seems to be a safe and effective treatment of SE in adults. Experience with IV VPA in the treatment of SE is too limited to recommend its use as a first-line agent.  Intravenous application of VPA is as effective as IV phenytoin. It is easy to use, better tolerated and can be used as an alternative to IV phenytoin in patients of benzodiazepine refractory SE in all seizure emergency situations including status epilepticus. The IV VPA may represent a third- or fourth-line option in cases of SE when other agents are ineffective or contraindicated.