Journal of the Korean Child Neurology Society 2009;17(1):102-106

High Dose Intravenous Valproic Acid for the Management of Prolonged Refractory Status Epilepticus : A Case Report of Satisfactory Neurologic Recovery.

Jee Yeon RIM 1 ; Young Il RHO

Affiliations

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Keywords

Refractory status epilepticus; Valproic acid

Country

Republic of Korea

Language

Korean

Abstract

Refractory status epilepticus (RSE) is defined as seizure activity that continues after treatment with conventional anticonvulsants. Mortality rates of range from 2% to 100%. RSE are associated with significant morbidity and high mortality as evidenced by older age of the patient, acute etiology for the seizure, no previous history of seizures, low initial Glasgow Coma Scale, and the significant duration of the RSE. An intravenous valproic acid (VPA) was suggested as a useful drug in controlling RSE. A continuous infusion VPA was an efficient method of rapidly achieving VPA concentrations in the upper region of the therapeutic range while minimizing adverse effects. A 10-year-old female suffered a generalized tonic clonic seizure that developed into refractory status epilepticus. Her Glasgow Coma Scale was deteriorated to 4. Status epilepticus was refractory to phenytoin, phenobarbital, midazolam, thiopental. After 4days of unsatisfactory control of seizure activity, high dose VPA was administered for 2 months. The clinical and electrolgraphic seizure improved and the patient has made an satisfactory neurologic recovery