Acute encephalopathy after intravenous administration of valproate in non‐convulsive status epilepticus

Embacher, Norbert; Karner, Elfriede; Wanschitz, Julia; Beer, Ronny; Trinka, Eugen

doi:10.1111/j.1468-1331.2006.01394.x

Cited by 21 publications

(15 citation statements)

References 6 publications

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“…Several studies confirm the safety profile of the VPA i.v. formulation, although cases of severe adverse effects, such as acute encephalopathy or liver failure in patients with mitochondrial disease, have been rarely reported [8,9]. VPA has proven to be effective in several types of SE [10] , and is now widely recommended for SE treatment after failure of first-line therapy; recent studies have shown no significant differences among VPA, PHT, or BDZ [10][11][12][13].…”

Section: Discussionmentioning

confidence: 96%

Clinical experience with intravenous valproate as first-line treatment of status epilepticus and seizure clusters in selected populations

Lapenta¹,

Morano²,

Casciato³

et al. 2013

International Journal of Neuroscience

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Section: Discussionmentioning

confidence: 96%

Clinical experience with intravenous valproate as first-line treatment of status epilepticus and seizure clusters in selected populations

Lapenta¹,

Morano²,

Casciato³

et al. 2013

International Journal of Neuroscience

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“…Die bei der paravenösen Injektion von Phenytoin gefürchteten Gewebenekrosen [4] sind für Valproinsäure nicht beschrieben. Als seltene und schwerwiegende unerwünschte Arzneimittelwirkungen sind unter Valproinsäure-Therapie in erster Linie toxische Leberschäden [1], Pankreatitiden sowie eine Valproinsäure-induzierte Encephalopathie [3,11] beschrieben. Besonders gefährdet sind hier neben Kindern und Patienten mit hepatischen Vorerkrankungen insbesondere Patienten mit einer unter intensivmedizinischen Bedingungen häufig unvermeidlichen Polytherapie.…”

Section: Sicherheit Und Verträglichkeit Von Intravenös Verabreichter unclassified

Kritische Stellungnahme zur Datenlage und zum Indikationsspektrum von intravenöser Valproinsäure

2007

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A critical appraisal of empirical evidence and indications for intravenous administration of valproic acid" Abstract Since the mid 1990s, intravenous valproic acid is available for the treatment of patients with partial and idiopathic generalised epilepsy for whom an oral therapy with valproic acid is not feasible. The efficacy and tolerability of the intravenous application has been demonstrated in numerous case reports and open studies, and no relevant differences between enteral and parenteral application of valproic acid were found. As an off-label-use, intravenous valproic acid is also used in the therapy of status epilepticus. In spite of cumulating evidence for the efficacy and tolerability of valproic acid for this indication, the current body of data does not allow a clear recommendation for the use of the substance in the therapy of status epilepticus. Therefore prospective controlled studies are needed." Key words valproic acidintravenous -therapystatus epilepticus -off-label use " Zusammenfassung Valproinsäu-re steht seit Mitte der 1990er Jahre zur intravenösen Behandlung von Patienten mit fokaler und idiopathisch generalisierter Epilepsie, bei denen eine orale Therapie mit Valproinsäure nicht möglich ist, zur Verfügung. Die Wirksamkeit und Verträglichkeit der intravenösen Therapie konnte in einer Vielzahl von Fallberichten und offenen Studien gezeigt werden. Wesentliche Unterschiede zur Therapie mit oraler Valproinsäure ergeben sich bei guter Bioäquivalenz beider Darreichungsformen nicht. Im Rahmen eines "Off-label"-Einsatzes wird intravenöse Valproinsäure zudem häufig zur Therapie des Status epilepticus eingesetzt. Trotz sich verdichtender Hinweise auf eine gute Wirksamkeit und Verträglichkeit auch für diese Indikation, lässt die Datenlage eine klare Empfehlung für Valproinsäure im Rahmen der Statustherapie gegenwär-tig nicht zu, so dass hier kontrollierte prospektive Studien erforderlich sind." Schlüsselwörter Valproinsäure -intravenös -Therapie -Status epilepticus -"Off-label"-Gebrauch

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“…A risk of VPA is the development of liver failure, pancreatitis and encephalopathy. The latter can be difficult to distinguish from ongoing SE and needs early diagnosis including EEG to prevent further, harmful infusion of VPA [51].…”

Section: In-hospital Treatmentmentioning

confidence: 99%

Status Epilepticus

Hagemann¹

2011

TOCCMJ

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Generalized convulsive status epilepticus (GCSE) is a neurological emergency with high mortality which needs immediate recognition and treatment. There is a variety of different categories of status epilepticus (SE) and the form and aetiology of status are important predictors for prognosis. As early treatment is beneficial out-of-hospital treatment can be advised. The first-line treatment of GCSE is lorazepam which can be followed by phenytoin and induction of coma by anaesthetics. Because of receptor changes short-term prognosis to stop seizures becomes worse with time and the longterm prognosis is worst in case of refractory SE. Non convulsive forms of SE can only be diagnosed with an EEG and should be treated more cautiously to prevent potentially harmful adverse events of therapy. Some of the modern anticonvulsants which are available for intravenous use may have good efficacy and tolerability but are not licensed for use in SE, yet. Therefore, they should only be used with neurology specialist advise. For all institutions it is advisable to consent on an in-house protocol which all physicians are familiar with. This review gives a pragmatic overview of diagnosis, classification, and treatment of SE.

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Acute encephalopathy after intravenous administration of valproate in non‐convulsive status epilepticus

Cited by 21 publications

References 6 publications

Clinical experience with intravenous valproate as first-line treatment of status epilepticus and seizure clusters in selected populations

Clinical experience with intravenous valproate as first-line treatment of status epilepticus and seizure clusters in selected populations

Kritische Stellungnahme zur Datenlage und zum Indikationsspektrum von intravenöser Valproinsäure

Status Epilepticus

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