Predictors and prognosis of status epilepticus treated with intravenous sodium valproate

To retrospectively review the efficacy of intravenous sodium valproate (VPAiv) treatment of status epilepticus (SE) and analyse predictive factors for seizure control and death.

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.

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).

For SE patients who received VPAiv treatment, the first-line VPAiv was effective. Initial leukocytosis and hypotension were factors that correlated with death.