Abstracts

Intravenous VPA has been approved for treatment of benzodiazepine-resistant status epilepticus (SE) in Norway. We are now performing a prospective registration of the effect of i.v. VPA in SE and serial attacks (SA) from 6 Norwegian hospitals., Data have been obtained from the first 41 adult patients, 23 women and 18 men, treated with i.v. VPA after having been unsuccessfully treated with benzodiazepines for SE/SA. The protocol suggested a VPA loading dose of 25 mg/kg over 30 min, followed by continuous infusion of 100 mg/hour for 24 hours., 29 patients were diagnosed with SE, 12 with SA. 19 had generalised tonic-clonic while 16 had complex-partial seizures as their main SE/SA seizure type. 6 had mixed or other type of seizures. Median VPA bolus dose was 1800 mg (range 700-2500). Median time to treatment of SE/SA for all patients was 3 h (range 0.3-72 h). For patients with complex partial SE/SA, median time to start of VPA was 4 h (range 0-72 h). Effect, defined as the lack of need of anaesthesia (barbiturates or propofol), showed that VPA was effective in 31 of 41 cases (76 %). Of the 10 cases requiring anaesthesia, 5 had a significant delay before starting treatment (20 to 72 hours). Moderate hypotension during bolus dose infusion was seen in one patient, but corrected easily with i.v. saline without complications. Otherwise, no side-effects were reported., VPA is safe and effective in the treatment of benzodiazepine-resistant SE/SA. SE/SA was stopped in 31 of 41 cases (76%). Lack of effect may be related to delayed treatment and too low loading dose.,