scholarly journals Experience in using injectable valproic acid (convulex) in patients with serial epileptic seizures and status epilepticus at the prehospital stage

2012 ◽  
Vol 0 (1S) ◽  
pp. 53
Author(s):  
Anna Valeryanovna Lebedeva ◽  
V A Karlov ◽  
A M Sidorov ◽  
V L Baratashvili ◽  
V E Khomutov
Keyword(s):  
Valproic Acid ◽  
Status Epilepticus ◽  
Epileptic Seizures

scholarly journals Valproic Acid Administration in Management of Status Epilepticus Causing Reye’s Syndrome

2021 ◽  
Vol 07 (01) ◽  
pp. 044-046
Author(s):  
Pooja Prabhakar Kamath
Keyword(s):  
Valproic Acid ◽  
Status Epilepticus ◽  
Hepatic Dysfunction ◽  
Rare Condition ◽  
Normal Serum ◽  
Reye's Syndrome ◽  
Serum Glutamic Oxaloacetic Transaminase ◽  
Viral Illness ◽  
Laboratory Investigations ◽  
Serum Ammonia

Abstract Introduction Valproic acid is commonly used to treat seizures in children. Regular use of valproic acid is known to cause hepatic dysfunction, and in extremely rare cases, it is known to have caused Reye’s syndrome. There are very few reports of Reye’s syndrome caused by valproic acid use. Methods A 2-year asymptomatic girl underwent modified Blalock–Taussig shunt surgery for correction of tetralogy of Fallot. Postoperatively the girl developed status epilepticus, which did not subside with initial use of intravenous midazolam and phenytoin sodium. She eventually responded to two doses of intravenous valproic acid administered 10 minutes apart. She developed depressed sensorium and was put on mechanical ventilation. The following day’s laboratory investigations revealed raised levels of serum ammonia, serum glutamic-oxaloacetic transaminase (SGOT), and serum glutamic-pyruvic transaminase (SGPT) with normal serum bilirubin. Thus, a diagnosis of Reye’s syndrome was established. The patient succumbed to disease 2 days later. Discussion Reye’s syndrome is a rare and a fulminant illness seen typically in children following a viral illness and/or use of salicylates or other medications. There are rare reports of Reye’s syndrome following use of medications like valproic acid. This patient had a noninflammatory encephalopathy with hepatic dysfunction following two doses of valproic acid. Conclusion There are very few reports on Reye’s syndrome in the literature as it is a rare condition and diagnosis is difficult. Knowledge of the presentation of Reye’s syndrome is essential for treatment and management. When using drugs like valproic acid in children, liver enzymes and serum ammonia levels should be monitored.

Neurologist, 26 years’ experience, Turkey

2020 ◽  
pp. 269-271
Author(s):  
Markus Reuber ◽  
Gregg H. Rawlings ◽  
Steven C. Schachter
Keyword(s):  
Status Epilepticus ◽  
Behavioral Problems ◽  
Psychiatric Treatment ◽  
Past History ◽  
Epileptic Seizures ◽  
Teenage Girl ◽  
The Third ◽  
Physical Injuries ◽  
Serious Infection ◽  
Different Types

This chapter explores the experience of a Neurologist who has seen many different types of Non-Epileptic Seizures, from very hyperactive and even aggressive movements to dissociative-like symptoms. It specifically considers the stories of three patients at different ages with different manifestations. The first patient was an older lady whose seizures seemed to be aggravated after menopause. Her past history revealed a serious infection during her first pregnancy, which had resulted in the loss of her baby. During her visit with the Neurologist, she had a seizure in which she was not able to speak, her eyes were deviated upward with eye blinking, and her face looked pale. The second patient was a teenage girl who had started to have seizures diagnosed as status epilepticus after she had been involved in an accident. Later, the Neurologist found out that she had not suffered any serious physical injuries in her head associated with the accident and that she was undergoing psychiatric treatment because of her behavioral problems. The third patient was in her twenties and had had seizures for several years, which always happened at night during sleep. The seizures were described as involving excessive movement and were happening three to four times a month.

scholarly journals OS3.1 Antiepileptic drugs and their association with depression, anxiety and subjective cognitive impairment in glioma patients

2019 ◽  
Vol 21 (Supplement_3) ◽  
pp. iii8-iii8
Author(s):  
P B van der Meer ◽  
M J B Taphoorn ◽  
M J van den Bent ◽  
L Dirven ◽  
J A F Koekkoek
Keyword(s):  
Valproic Acid ◽  
Cognitive Impairment ◽  
Antiepileptic Drugs ◽  
Karnofsky Performance Status ◽  
Performance Status ◽  
Depression Scale ◽  
Epileptic Seizures ◽  
Common Symptom ◽  
Subjective Cognitive Impairment ◽  
Confounding Variables

Abstract BACKGROUND Epileptic seizures are a common symptom in glioma patients and generally treated with antiepileptic drugs (AEDs), which are considered to have the potential of mood-modulating and neurocognitive adverse effects. This observational study aimed to assess the independent association between AEDs and depression, anxiety and subjective cognitive impairment in glioma patients. MATERIAL AND METHODS Use of AEDs was defined as a categorical variable (none or at least one). Depression and anxiety were measured with the Hospital Anxiety and Depression Scale, while subjective cognitive impairment was measured with the Medical Outcomes Study-Cognitive Functioning Scale. Hierarchical multivariable logistic regression analyses were performed for each outcome separately. Besides use of AEDs, other confounding variables such as seizure severity and Karnofsky Performance Status score were included. Analyses were repeated for the two most commonly prescribed AEDs separately, levetiracetam or valproic acid, with the same confounding variables. RESULTS A total of 272 grade II-IV glioma patients were included in the study, of which 68% used at least one AED. Prevalence of depression was 10% for patients taking 0 AEDs and increased significantly to 21% (adjusted Odds Ratio [aOR]=2.4 [95%Confidence Interval {CI}=1.0–5.8]) for those taking ≥1. Prevalence was not significantly different between patients using 0 and using ≥1 AEDs for both anxiety (19% versus 26%, aOR=1.1 [95%CI=0.6–2.2]) and subjective cognitive impairment (16% versus 21%, aOR=1.2 [95%CI=0.6–2.5]). Although prevalences of depression (13% versus 23%, aOR=1.6 [95%CI=0.8–3.2]) and anxiety (17% versus 31%, aOR=1.8 [95%CI=0.9–3.3]), but not subjective cognitive impairment (20% versus 18%, aOR=1.7 [95%=0.4–1.4]), differed significantly between patients not using and using levetiracetam, these associations were not independent. No significant differences were found between patients not using and using valproic acid on the three outcome measures. CONCLUSION After adjustment of confounders, only depression was associated with the use of AED’s. No such relation was found for anxiety or subjective cognitive impairment. Use of levetiracetam or valproic acid were not independently related to depression, anxiety or subjective cognitive impairment.

scholarly journals Platelet counts in epileptic children receiving valproic acid

2020 ◽  
Vol 60 (1) ◽  
pp. 13-7
Author(s):  
Lilik Indrayati ◽  
Fadhilah Tia Nur ◽  
Bambang Soebagyo
Keyword(s):  
Valproic Acid ◽  
Epileptic Seizures ◽  
Term Treatment ◽  
Common Adverse Event ◽  
Platelet Counts ◽  
Central Java ◽  
Long Term Treatment ◽  
Epileptic Children ◽  
The Brain

Background Epileptic seizures are a transient occurrence resulting from abnormal, excessive, or synchronous neural activity in the brain. Epilepsy requires long-term treatment, increasingly larger doses, and combination therapy. Anti-epileptic drugs (AEDs), especially valproic acid (VPA), are the main treatment of choice. Thrombocytopenia is the most common adverse event from AEDs. Objective To evaluate platelet counts in epileptic children receiving valproic acid monotherapy vs. polytherapy. Methods This analytic, observational, retrospective cohort study was conducted in children with epilepsy below 18 years of age and treated in Dr. Moewardi Hospital, Surakarta, Central Java. Subjects had received VPA treatment for at least 6 months, either as monotherapy or polytherapy. There were 40 subjects in each group (VPA monotherapy vs. VPA polytherapy). The exclusion criteria were patients who had thrombocytopenia and did not take valproic acid regularly. The data was taken from laboratory and the outcome assessed was decreasing of platelet count. Results  Administration of VPA as monotherapy vs. polytherapy was not significantly associated with incidence of thrombocytopenia. However, duration of VPA use > 2 years was associated with significantly greater proportion of thrombocytopenia, with OR 33.0 (95%CI 4.157 to 261.962; P=0.001) compared to VPA use < 2 years. Similarly, VPA dose of >30 mg/kg/day was significantly associated with greater proportion of thrombocytopenia, with OR 4.081 (95%CI 1.337 to 12.458; P=0.013) compared to <30 mg/kg/day dosage. Conclusion Incidence of thrombocytopenia is not significantly different between VPA as a  monotherapy and polytherapy. However, higher VPA dose and longer VPA duration are associated with higher proportion of thrombocytopenia.

Parkinson's disease: Less epileptic seizures more status epilepticus

2014 ◽  
Vol 108 (2) ◽  
pp. 349-354 ◽  
Author(s):  
Berend Feddersen ◽  
Jan Rémi ◽  
Marion Einhellig ◽  
Cordula Stoyke ◽  
Philipp Krauss ◽  
...  
Keyword(s):  
Parkinson’S Disease ◽  
Parkinson's Disease ◽  
Status Epilepticus ◽  
Epileptic Seizures

scholarly journals Increased Occurrence of Valproic Acid-Induced Hyperammonemia in Carriers of T1405N Polymorphism in Carbamoyl Phosphate Synthetase 1 Gene

2013 ◽  
Vol 2013 ◽  
pp. 1-4 ◽  
Author(s):  
Piotr K. Janicki ◽  
Dmitri Bezinover ◽  
Marek Postula ◽  
Robert S. Thompson ◽  
Jayant Acharya ◽  
...  
Keyword(s):  
Valproic Acid ◽  
Significant Risk ◽  
Epileptic Seizures ◽  
Normal Liver ◽  
Significant Risk Factor ◽  
Ammonia Level ◽  
Carrier Status ◽  
Carbamoyl Phosphate ◽  
Caucasian Patients ◽  
Patients With Epilepsy

Numerous cases of severe and life-threatening hyperammonemia (HA) related to the treatment of epileptic seizures with valproic acid (VPA) have been previously reported in the medical literature. The aim of this prospective, multicenter study was to verify the putative association between T1405 polymorphism and occurrence of VPA-induced HA in the cohort of 142 adult Caucasian patients with epilepsy treated with VPA for at least 1 year and with normal liver functions. The nonsynonymous T1405N polymorphism genotyping was performed by real-time TaqMan PCR genotyping. In addition to plasma ammonia level, concentrations of liver enzymes and total VPA were measured in plasma with standard laboratory methods. HA (defined as ammonia plasma level >65 μmol/L) was observed in total of 11 (7.7%) of patients treated with VPA, and the carrier status for the investigated polymorphism was significantly (P=0.009, odds ratio 5.4 with 95% confidence interval of 1.58–18.43) associated with the occurrence of HA. The results of this study support a notion that in the Caucasian patients with epilepsy undergoing VPA therapy, a T1405N (4217C > A, rs1047891) nonsynonymous variant was a significant risk factor for the occurrence of HA, even in patients with normal plasma levels of VPA.

Sign in / Sign up

Export Citation Format

Share Document