Somsak Tiamkao1, Kittisak Sawanyawisuth. 1. Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. somtia@kku.ac.th
Abstract
OBJECTIVE: To retrospectively review the efficacy of intravenous sodium valproate (VPAiv) treatment of status epilepticus (SE) and analyse predictive factors for seizure control and death. METHODS: Patients were included with a diagnosis of SE who had received intravenous sodium valproate (VPAiv) during 2005-2007 at Srinagarind Hospital, Khon Kaen University, Thailand. Logistic regression analysis with a stepwise approach was used to evaluate the predictors of seizure control and death. RESULTS: Thirty-two cases were diagnosed as SE with VPAiv treatment; 12 and 20 patients received VPAiv as the first- and second-line therapy, respectively. SE ceased in nine out of 12 patients (75%) and in seven out of 20 (35%) patients with VPAiv as the first- and second-line therapy, respectively. No serious cardiovascular compromise was recorded. The first-line therapy of VPAiv was the only factor that was significantly related to seizure control with an adjusted odds ratio [OR] of 5.571; 95% confidence interval [CI] of 1.128-27.523. Initial leukocytosis and hypotension were significantly associated with death (adjusted OR: 22.765, 95% CI: 1.176-440.640 and adjusted OR: 37.591, 95% CI: 3.035-465.571, respectively). CONCLUSION: For SE patients who received VPAiv treatment, the first-line VPAiv was effective. Initial leukocytosis and hypotension were factors that correlated with death.
OBJECTIVE: To retrospectively review the efficacy of intravenous sodium valproate (VPAiv) treatment of status epilepticus (SE) and analyse predictive factors for seizure control and death. METHODS:Patients were included with a diagnosis of SE who had received intravenous sodium valproate (VPAiv) during 2005-2007 at Srinagarind Hospital, Khon Kaen University, Thailand. Logistic regression analysis with a stepwise approach was used to evaluate the predictors of seizure control and death. RESULTS: Thirty-two cases were diagnosed as SE with VPAiv treatment; 12 and 20 patients received VPAiv as the first- and second-line therapy, respectively. SE ceased in nine out of 12 patients (75%) and in seven out of 20 (35%) patients with VPAiv as the first- and second-line therapy, respectively. No serious cardiovascular compromise was recorded. The first-line therapy of VPAiv was the only factor that was significantly related to seizure control with an adjusted odds ratio [OR] of 5.571; 95% confidence interval [CI] of 1.128-27.523. Initial leukocytosis and hypotension were significantly associated with death (adjusted OR: 22.765, 95% CI: 1.176-440.640 and adjusted OR: 37.591, 95% CI: 3.035-465.571, respectively). CONCLUSION: For SE patients who received VPAiv treatment, the first-line VPAiv was effective. Initial leukocytosis and hypotension were factors that correlated with death.