Valproate versus diazepam for generalized convulsive status epilepticus: a pilot study
European Journal of Neurology, 05/16/2011
Chen WB et al. – Both intravenous (IV) valproate (VPA) and continuous diazepam(DZP) infusion are effective second–line anticonvulsants for generalized convulsive status epilepticus (GCSE). IV VPA was well tolerated and free of respiratory depression and hypotension, which may develop in the DZP group. Outcome parameters were not significantly different between groups.Methods
- After failure of first-line anticonvulsants treatment, patients with GCSE were randomized to receive either IV VPA or continuous DZP infusion.
- Primary outcome was the proportion of patients with effective control.
- Side effects were also evaluated.
- 66 cases enrolled, with the mean age of 41 ± 21 years.
- Seizure was controlled in 56% (20/36) of the DZP group and 50% (15/30) of the VPA group (P = 0.652).
- No patient in the VPA group developed respiratory depression, hypotension, or hepatic dysfunction, whereas in the DZP group, 5.5% required ventilation and 5.5% developed hypotension.
- Time (hour) for regaining consciousness after control was near-significantly longer in the DZP group [13(3.15–21.5)] than in the VPA group [3(0.75-11)] (P = 0.057).
- Virus encephalitis and long duration of GCSE were independent risk factors of drug resistance.