Treatment of status epilepticus by sodium valproate

The authors studied the action of valproate with single loading dose of 25 mg/kg, by oral or rectal way, in the treatment of a status epilepticus occurring in 22 patients: 12 patients with generalized status epilepticus, 2 patients with myoclonic status, 2 patients with absence status and 6 patients with motor partial status. In 8 cases, an EEG was performed during the treatment. Results were satisfactory: the status was controlled in 16 cases (73%) in a mean time of 19 min. Plasma levels of valproate approached 55 mg/l at the 20th min after the loading dose. In 6 cases (27%), the status was not controlled, with a plasma level of 33 mg/l at the 20th min. No side effect was observed. This work shows that, for the treatment of status epilepticus, a loading dose of valproate by oral or rectal way is therapeutically equivalent to diazepam and clobazam.