Valproic acid for children below 2 years of age with epilepsy
Osama Y Muthaffar1, Salha M Almahmudi1, Muna O Alrabghi1
1From the Department of Pediatrics (Muthaffar), and from the Faculty of Pharmacy (Almahmudi, Alrabghi, Bin Mahfouz, Alfawaz), King Abdulaziz University, Jeddah, Kingdom of Saudi Arabia.
Insights
Valproic acid (VPA) is a safe and effective epilepsy treatment for children under two years old. This study found significant seizure improvement in 64% of young patients, with 22% becoming seizure-free.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Epilepsy Research
Background:
- Epilepsy affects infants and young children, necessitating effective and safe treatment options.
- Valproic acid (VPA) is a broad-spectrum antiepileptic drug with established efficacy.
- Limited data exists on VPA's use in children under two years old.
Purpose of the Study:
- To evaluate the efficacy and safety of valproic acid (VPA) in children under two years of age.
- To characterize patients under two years old treated with VPA for epilepsy.
- To review the role and safety profile of VPA in this specific pediatric population.
Main Methods:
- Retrospective chart review of 50 children under two years old diagnosed with epilepsy.
- Study conducted at King Abdulaziz University Hospital, Jeddah, Saudi Arabia (January 2016 - January 2020).
- Analysis of seizure improvement, VPA safety, and relevant laboratory parameters.
Main Results:
- 64% of patients (32/50) experienced over 50% seizure reduction with VPA.
- 22% of patients (11/50) achieved complete seizure freedom.
- VPA was generally well-tolerated, with mild, reversible side effects like lethargy in two patients. No significant hematological or ammonia abnormalities were observed.
Conclusions:
- Valproic acid (VPA) is a safe and effective antiepileptic treatment for infants and children under two years old.
- The study supports the use of VPA in this young pediatric population for epilepsy management.
- Further research can explore long-term outcomes and optimal dosing strategies for VPA in this age group.
Objectives:
To evaluate the efficacy of valproic acid (VPA) in a cohort of children below 2 years of age. We also aim to review the characteristics of such patients and the role and safety of VPA for this age group.
Methods:
A retrospective chart review conducted at King Abdulaziz University Hospital, Jeddah, Kingdome of Saudi Arabia, for children below 2 years of age diagnosed with epilepsy and treated with valproic acid from January 2016 to January 2020.
Results:
The cohort for this study includes 50 children below the age of 2 years (25 males, 25 females). Aged 3 months to 23 months at commencing valproic acid. The mean age of seizure onset was 9 months and the mean age of starting valproic acid was 16 months. Thirty-two patients (64%) had more than 50% seizure improvement after valproic acid. Eleven patients (22%) were seizure-free. No statistical significance abnormalities in blood count indices and ammonia were seen during the treatment period. Two patients had dose-related lethargy that improved after decreasing their dosage. Asymptomatic mild elevation in glutamate dehydrogenase was noticed in 18% of patients.
Conclusion:
Using valproic acid in infants and children below the age of 2 years can be considered as a safe and effective treatment option for epilepsy in this age group.
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