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Sodium valproate compared to phenytoin in treatment of status epilepticus

BACKGROUND: Status epilepticus (SE) is a neurological emergency which can be life‐threatening. Several medical regimens are used in order to control it. In this study, we intended to evaluate the clinical efficacy and tolerability of sodium valproate and intravenous phenytoin (IV PHT) in the control...

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Autores principales: Amiri‐Nikpour, Mohammad Reza, Nazarbaghi, Surena, Eftekhari, Parisa, Mohammadi, Sedra, Dindarian, Sina, Bagheri, Mahdi, Mohammadi, Hozan
Formato: Online Artículo Texto
Lenguaje:English
Publicado: John Wiley and Sons Inc. 2018
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943732/
https://www.ncbi.nlm.nih.gov/pubmed/29761006
http://dx.doi.org/10.1002/brb3.951
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author Amiri‐Nikpour, Mohammad Reza
Nazarbaghi, Surena
Eftekhari, Parisa
Mohammadi, Sedra
Dindarian, Sina
Bagheri, Mahdi
Mohammadi, Hozan
author_facet Amiri‐Nikpour, Mohammad Reza
Nazarbaghi, Surena
Eftekhari, Parisa
Mohammadi, Sedra
Dindarian, Sina
Bagheri, Mahdi
Mohammadi, Hozan
author_sort Amiri‐Nikpour, Mohammad Reza
collection PubMed
description BACKGROUND: Status epilepticus (SE) is a neurological emergency which can be life‐threatening. Several medical regimens are used in order to control it. In this study, we intended to evaluate the clinical efficacy and tolerability of sodium valproate and intravenous phenytoin (IV PHT) in the control of SE. METHODS: One hundred and ten consecutive patients suffering from benzodiazepine refractory SE who were referred to the emergency ward from March 2014 to March 2015 were randomly divided into two groups. The first group received intravenous sodium valproate, 30 mg/kg as loading dose and then 4–8 mg/kg every 8 hr as maintenance regimen. The second group received IV PHT 20 mg/kg as loading dose and then 1.5 mg/kg for 8 hr as maintenance therapy. All patients were monitored for vital signs every 2 hr up to 12 hr. The patients were also followed up for 7 days regarding drug response and adverse effects. RESULTS: The administration of sodium valproate and phenytoin respectively resulted in seizure control in 43 (78.18%) and 39 (70.90%) of the patients within 7 days of drug administration (p = .428). Seven‐day mortality rate was similar in both groups (12.73% vs. 12.73%; p = .612). There was no significant difference in adverse effects between two groups. CONCLUSION: Sodium valproate is preferred to IV PHT for treatment and control of SE due to its higher tolerability and lower hemodynamic instability.
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spelling pubmed-59437322018-05-14 Sodium valproate compared to phenytoin in treatment of status epilepticus Amiri‐Nikpour, Mohammad Reza Nazarbaghi, Surena Eftekhari, Parisa Mohammadi, Sedra Dindarian, Sina Bagheri, Mahdi Mohammadi, Hozan Brain Behav Original Research BACKGROUND: Status epilepticus (SE) is a neurological emergency which can be life‐threatening. Several medical regimens are used in order to control it. In this study, we intended to evaluate the clinical efficacy and tolerability of sodium valproate and intravenous phenytoin (IV PHT) in the control of SE. METHODS: One hundred and ten consecutive patients suffering from benzodiazepine refractory SE who were referred to the emergency ward from March 2014 to March 2015 were randomly divided into two groups. The first group received intravenous sodium valproate, 30 mg/kg as loading dose and then 4–8 mg/kg every 8 hr as maintenance regimen. The second group received IV PHT 20 mg/kg as loading dose and then 1.5 mg/kg for 8 hr as maintenance therapy. All patients were monitored for vital signs every 2 hr up to 12 hr. The patients were also followed up for 7 days regarding drug response and adverse effects. RESULTS: The administration of sodium valproate and phenytoin respectively resulted in seizure control in 43 (78.18%) and 39 (70.90%) of the patients within 7 days of drug administration (p = .428). Seven‐day mortality rate was similar in both groups (12.73% vs. 12.73%; p = .612). There was no significant difference in adverse effects between two groups. CONCLUSION: Sodium valproate is preferred to IV PHT for treatment and control of SE due to its higher tolerability and lower hemodynamic instability. John Wiley and Sons Inc. 2018-03-23 /pmc/articles/PMC5943732/ /pubmed/29761006 http://dx.doi.org/10.1002/brb3.951 Text en © 2018 The Authors. Brain and Behavior published by Wiley Periodicals, Inc. This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.
spellingShingle Original Research
Amiri‐Nikpour, Mohammad Reza
Nazarbaghi, Surena
Eftekhari, Parisa
Mohammadi, Sedra
Dindarian, Sina
Bagheri, Mahdi
Mohammadi, Hozan
Sodium valproate compared to phenytoin in treatment of status epilepticus
title Sodium valproate compared to phenytoin in treatment of status epilepticus
title_full Sodium valproate compared to phenytoin in treatment of status epilepticus
title_fullStr Sodium valproate compared to phenytoin in treatment of status epilepticus
title_full_unstemmed Sodium valproate compared to phenytoin in treatment of status epilepticus
title_short Sodium valproate compared to phenytoin in treatment of status epilepticus
title_sort sodium valproate compared to phenytoin in treatment of status epilepticus
topic Original Research
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5943732/
https://www.ncbi.nlm.nih.gov/pubmed/29761006
http://dx.doi.org/10.1002/brb3.951
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