SODIUM VALPROATE VERSUS FOSPHENYTOIN FOR STATUS EPILEPTICUS IN CHILDREN- A RANDOMIZED CONTROL TRIAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2019, Vol 8, Issue 18
Abstract
BACKGROUND Status epilepticus (SE) is a life-threatening neurological emergency in children associated with high morbidity and mortality. Phenytoin/fosphenytoin is the currently recommended first choice second line treatment in children, although there is lack of evidence for its use and it is associated with significant side effects. Emerging evidence suggests that intravenous (IV) sodium valproate may be more effective with fewer side effects. The objective of this study was to compare the efficacy and safety of IV sodium valproate with IV fosphenytoin as a second line treatment for SE in Indian children. METHODS This is a prospective randomized control trial conducted in the department of paediatric emergency of Raja Mirasudar Hospital attached to Thanjavur Medical College, Thanjavur, South India, from October 2017 to July 2018 among 30 children aged 2 years to 12 years admitted for SE, and in whom seizure did not terminate even with 2 doses of benzodiazepines. 20 mg Phenytoin equivalent (PE)/kg of fosphenytoin (FPHT) over 7 minutes or 20 mg/kg of sodium valproate (SVP) over 5 minutes. Clinical cessation of seizures five minutes following the completion of the infusion of the study medication was the expected primary outcome. RESULTS Sodium valproate terminated seizures earlier than fosphenytoin (P=0.001). There was no significant difference between the two drugs with respect to recurrence of seizures within 24 hours (p>0.999). The adverse events did not differ significantly between the two groups (p=0.715). CONCLUSIONS Sodium valproate may be an effective alternative to fosphenytoin in the management of SE in children.
Authors and Affiliations
Rajasekar S. , Selvakumar P, Mohamed Nazar R
Keywords
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- EP ID EP616990
- DOI 10.14260/jemds/2019/328
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