Evaluation of the efficacy of sodium valproate in convulsive status epilepticus following to ıschemic stroke

Abstract

Objective : Convulsive status epilepticus (CSE) is very rarely observed after ischaemic stroke. Sodium valproate (SV) is one of the agents used in the treatment of CSE, but its role still controversial, and its degree of efficacy in treating CSE that develops following stroke is unclear. Method : We evaluated 19 patients who were treated with intravenous (IV) SV (20 mg/kg, 2 mg/kg/h-12h) after diazepam. Patients’ modified Rankin scores (mRS), SE types, and changes in biochemical parameters after treatment were assessed. Results : CSE was successfully treated in 12 (63.15%) patients. Side effects such as hypotension and allergic reactions were observed in two patients. Refractory SE development was observed in 5 (29.4%) patients with high mRS (˃ 3). No significant deterioration in patients’ laboratory evaluations, conducted before and after status, was observed. Conclusion : SV may be safe and effective in the treatment of CSE observed after ischaemic stroke, especially in patients with low mRS.

Effect of Sodium Valproate Treatment on the Cardiac Index in New Cases with Status Epilepticus

“…Nevertheless, limited studies reported the negative effects of sodium valproate on cardiac function. For example, Özdemir et al [16] examined the side effects of sodium valproate [20 mg/kg and 2 mg/kg/h-12h] in 19 adult patients with status epilepticus following ischemic stroke. They demonstrated that sodium valproate led to systemic side effects such as hypotension, abnormal heart rate, and respiratory failure in these patients.…”

“…Sodium valproate interacts with drugs such as phenobarbital, phenytoin, carbamazepine, lamotrigine, rifampin, ethosuximide, and primidone [15]. Recent studies have supposed that sodium valproate may result in cardiac failure in children [16]; however, its effect on cardiac function is still controversial. Therefore, researching the effect of sodium valproate on heart function and structure in children is valuable for the prevention of heart problems in these cases.…”