Dilara Mermi Dibek1, İbrahim Öztura2, Barış Baklan2. 1. Department of Neurology, Clinical Neurophysiology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey. dilara_mermi@hotmail.com. 2. Department of Neurology, Clinical Neurophysiology, Faculty of Medicine, Dokuz Eylul University, İzmir, Turkey.
Abstract
INTRODUCTION AND AIM: Valproic acid (Na valproate) is a broad-spectrum anti-seizure medication used in children and adolescents. It is thought to have fewer adverse effects; however, recent studies have restricted its use in women of reproductive age due to the teratogenic impacts on cognition. Although alternative drugs have been used to treat patients in clinical follow-up, some patients have to return to using valproic acid. Our study aimed to determine the rate of return to valproic acid treatment in female patients with follow-up in our centre and the reasons for the return. MATERIALS AND METHODS: Female patients with genetic generalized epilepsy who were followed up in our centre were included in the study. Patient data were retrospectively obtained from file records. The patients were grouped by seizure subgroups, antiepileptic treatment used, electroencephalography characteristics, and seizure treatment response. RESULTS: Sixty-three (31.7%) of the 199 patients had to return to VPA treatment. When the reasons for the discontinuation of other drugs were examined, non-response to treatment was found in 80.0% of patients, adverse medication effects in 18.3%, and 1.7% continued voluntarily. Patients who are JAE subtypes were more likely to return to VPA treatment than GTCS alone subtypes. A total of 7.4% of patients converted to VPA therapy had continued myoclonic seizures compared with 20.4% of patients treated with alternative drugs. CONCLUSION: VPA treatment is not used as the first choice in females of reproductive age; however, some patients will only achieve seizure control with valproate, especially those with myoclonic seizures and JAE.
INTRODUCTION AND AIM: Valproic acid (Na valproate) is a broad-spectrum anti-seizure medication used in children and adolescents. It is thought to have fewer adverse effects; however, recent studies have restricted its use in women of reproductive age due to the teratogenic impacts on cognition. Although alternative drugs have been used to treat patients in clinical follow-up, some patients have to return to using valproic acid. Our study aimed to determine the rate of return to valproic acid treatment in female patients with follow-up in our centre and the reasons for the return. MATERIALS AND METHODS: Female patients with genetic generalized epilepsy who were followed up in our centre were included in the study. Patient data were retrospectively obtained from file records. The patients were grouped by seizure subgroups, antiepileptic treatment used, electroencephalography characteristics, and seizure treatment response. RESULTS: Sixty-three (31.7%) of the 199 patients had to return to VPA treatment. When the reasons for the discontinuation of other drugs were examined, non-response to treatment was found in 80.0% of patients, adverse medication effects in 18.3%, and 1.7% continued voluntarily. Patients who are JAE subtypes were more likely to return to VPA treatment than GTCS alone subtypes. A total of 7.4% of patients converted to VPA therapy had continued myoclonic seizures compared with 20.4% of patients treated with alternative drugs. CONCLUSION: VPA treatment is not used as the first choice in females of reproductive age; however, some patients will only achieve seizure control with valproate, especially those with myoclonic seizures and JAE.
Authors: Kimford J Meador; Gus A Baker; Nancy Browning; Morris J Cohen; Rebecca L Bromley; Jill Clayton-Smith; Laura A Kalayjian; Andres Kanner; Joyce D Liporace; Page B Pennell; Michael Privitera; David W Loring Journal: Lancet Neurol Date: 2013-01-23 Impact factor: 44.182