comparative assessment the efficacy of intravenous infusion of sodium valproate and phenytoin in the treatment of status epilepticus

Status epilepticus [SE] is a type of persistent lasting seizure with high mortality and morbidity. Numerous medications are suggested for the treatment of SE, two of which are sodium valproate and phenytoin. The purpose of this study is to conduct a comparison between the efficiencies of intravenous sodium valproate and phenytoin in the treatment of this type of epilepsy. This is a clinical trial study conducted on SE-suffering patients admitted to the emergency departments of Al-Zahra and Ayatollah Kashani Medical Centers of Isfahan in 2009 and 2010. The patients were randomly assigned into two groups and taken under treatment, separately by intravenous infusion sodium valproate and phenytoin. No significant difference was observed between the two groups [at P = 0.06]. In terms of incidence of the clinical complications, the incidence of clinical complications in the two groups was significantly different [at P = 0.03]. Based on the findings the efficiency of sodium valproate is larger than that of the phenytoin, and thus, the treatment by sodium valproate is preferred over the treatment by phenytoin

Antiepileptic drugs: a consideration of clinical and biochemical outcome in patients with epilepsy

The challenge of antiepileptic drugs [AEDs] management is to attain the best compromise between the desire to maximize seizure control and the need to keep side-effects within tolerable limits for the individual patient. To reduce devastation in Iranian epileptic patients, the aim of this study was to explore the overall outcome following AEDs prescription. A cross sectional study of 36 patients located at the epilepsy ward, conducted to Isfahan Neurosciences Research Centre was carried out during the year 2011. Female [n = 17] and male subjects [n = 19] with a mean age of 27 years [range; 7-74 years] were studied. Variables including, sex, age, age of seizure onset, type, and number of AEDs, biochemical and hematological data were recorded in d-Base and statistical analyses were performed using SPSS [version 18] for windows. The main drug to control seizure attack was carbamazepine and valproic-acid. The following tests were the most frequently influenced; alkaline phosphatase [AP], lymphocyte [Lymph], white blood cell [WBC] counts and hemoglobin [Hgb]. There was a significant increase in [AP] [mean; 534.6 u/l; [P = 0.02] in three patients and [Lymph] [55%; [43-84]%; [P = 0.04] in seven patients. WBC was lower than 4400 mm[3] [P = 0.02] in six patients. Hgb was significantly lower in 70.6% of women [11.8; [10-14.2] g/dl; [P = 0.04] and 68.4% of men population [12.3; [9.7-13.8] g/dl; [P = 0.01]. Mean age of epilepsy onset was 15.6 years [range: Birth-74 years]. Analysis of drug prescriptions showed that the incidence of monotherapy and polypharmacy [2 up to six AEDs simultaneously] was 19.4% plus 80.6% respectively. In Iranian epileptic population, effectiveness of treatment should be attributed by the close supervising of AEDs in relation to clinical circumstance, laboratory data, and therapeutic drug monitoring. Any significant change in patients' biochemical and hematological data may require close verifying for the rapid detection of severe anemia, leukopenia, lymphocytosis, osteomalacia, or liver failure