Chang Yu-Ching, Lin Jainn-Jim, Wang Huei-Shyong, Chou Min-Liang, Hung Po-Cheng, Hsieh Meng-Ying
Division of Pediatric Neurology, Chang Gung Children's Hospital and Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan.
Acta Neurol Taiwan. 2010 Jun;19(2):100-6.
Valproate has been widely used in controlling various kinds of seizures. Intravenous forms of valproate control seizures in a more rapid and efficacious pattern than oral forms. We evaluated the effectiveness and adverse effects of intravenous valproate for controlling seizures in Taiwanese children under 18 years old.
Retrospective chart reviews were performed on 137 pediatric patients receiving valproate infusion from January 2003 to December 2006. Patients were divided into 4 groups as follows: (1) previous use of other antiepileptic drugs (AEDs) (n=59), (2) previous use of oral valproate (n=8), (3) previous use of other AEDs and valproate (n=32), (4) first time use of valproate (n=38). The indications for using intravenous valproate include status epilepticus, repetitive seizures, prophylactic use for brain operations or in cases where oral administration was not feasible due to medical problems.
The mean age was 8±6.22 years old and the average dose was 31.2±26.45 mg/kg/day. The mean duration of usage was 7.8±6.99 days. Eight patients failed to respond to intravenous valproate and the AED was shifted to other drugs. Thirty-two patients achieved successful seizure control after adding other AEDs following intravenous valproate. The seizure control rate in our study was 71%, and six patients died of complications associated with an underlying disorder. An allergic reaction (skin rash) was found in 1 patient, while no serious adverse effects were noted in our patients.
Intravenous valproate is effective and safe in controlling seizures in children who are either valproate naive or not.
丙戊酸盐已被广泛用于控制各种癫痫发作。静脉注射形式的丙戊酸盐比口服形式能更快速有效地控制癫痫发作。我们评估了静脉注射丙戊酸盐对台湾18岁以下儿童癫痫发作的控制效果及不良反应。
对2003年1月至2006年12月期间接受丙戊酸盐静脉输注的137例儿科患者进行回顾性病历审查。患者分为以下4组：（1）既往使用过其他抗癫痫药物（AEDs）（n = 59），（2）既往使用过口服丙戊酸盐（n = 8），（3）既往使用过其他AEDs和丙戊酸盐（n = 32），（4）首次使用丙戊酸盐（n = 38）。静脉注射丙戊酸盐的适应证包括癫痫持续状态、反复癫痫发作、脑手术预防性使用或因医疗问题无法口服给药的情况。
平均年龄为8±6.22岁，平均剂量为31.2±26.45mg/kg/天。平均使用时间为7.8±6.99天。8例患者对静脉注射丙戊酸盐无反应，抗癫痫药物改为其他药物。32例患者在静脉注射丙戊酸盐后加用其他AEDs后癫痫发作得到成功控制。我们研究中的癫痫发作控制率为71%，6例患者死于与基础疾病相关的并发症。1例患者出现过敏反应（皮疹），而我们的患者未观察到严重不良反应。
静脉注射丙戊酸盐对未使用过丙戊酸盐或已使用过丙戊酸盐的儿童控制癫痫发作有效且安全。
