IV Sodium Valproate vs Phenytoin for Status Epilepticus
IV Sodium Valproate vs Phenytoin for Status Epilepticus
SE patients treated at Srinagarind Hospital, Khon Kaen University, Thailand between 2003 and 2010 were enrolled. The inclusion criteria were patients with an age of more than 15 years and received either intravenous phenytoin or intravenous sodium valproate as the first-line treatment.
Status epilepticus (SE) is a condition with persistent seizure more than 5 minutes or the patient does not gain the consciousness during the interictal period. Generalized convulsive SE is defined as recurrent convulsive seizures that may be overt or subtle, symmetric or asymmetric, and are associated with profound coma and bilateral, although often has asymmetric, ictal discharges on electroencephalogram (EEG). Non-convulsive SE is defined as SE with a change in behavior and/or mental processes from baseline associated or associated with continuous epileptiform discharges in the EEG or in response to treatment.
Data were retrieved from medical records including baseline characteristics, previous medical illnesses, causes of SE, laboratory findings, numbers of AED usage, and outcomes of treatment. The outcomes of treatment were numbers of patients with clinically-controlled seizure, time to seizure control, admission duration, patient status after treatment, change of functional status after treatment, and death. Time to seizure control was identified by the total minutes spent from the start of SE treatment to the time until there was no clinical evidence of seizure. Seizure control was defined clinically and/or by EEG. Patient status after treatment was defined by patient's functional capacity at the discharge date from the hospital and categorized as dependent or non-dependent status. The dependent status was defined as a condition that the patients needed someone to assist them daily life activities and equal to modified Rankin scale (mRs) of two or more. Worsening of functional outcome was defined by change of functional outcome to dependent status or death at discharge date. Mortality rate and duration of treatment were recorded.
Baseline characteristics between phenytoin and sodium valproate group were compared by descriptive statistics. All outcome variables were also tested for the differences between those treated with phenytoin and sodium valproate. Wilcoxon rank sum or student t-test and Fisher's exact tests or Chi-square test were applied to compare the differences in numbers and proportions between the two groups where appropriate. The study protocol was approved by the ethics committee on human research of Khon Kaen University (HE541319).
Methods
SE patients treated at Srinagarind Hospital, Khon Kaen University, Thailand between 2003 and 2010 were enrolled. The inclusion criteria were patients with an age of more than 15 years and received either intravenous phenytoin or intravenous sodium valproate as the first-line treatment.
Status epilepticus (SE) is a condition with persistent seizure more than 5 minutes or the patient does not gain the consciousness during the interictal period. Generalized convulsive SE is defined as recurrent convulsive seizures that may be overt or subtle, symmetric or asymmetric, and are associated with profound coma and bilateral, although often has asymmetric, ictal discharges on electroencephalogram (EEG). Non-convulsive SE is defined as SE with a change in behavior and/or mental processes from baseline associated or associated with continuous epileptiform discharges in the EEG or in response to treatment.
Data were retrieved from medical records including baseline characteristics, previous medical illnesses, causes of SE, laboratory findings, numbers of AED usage, and outcomes of treatment. The outcomes of treatment were numbers of patients with clinically-controlled seizure, time to seizure control, admission duration, patient status after treatment, change of functional status after treatment, and death. Time to seizure control was identified by the total minutes spent from the start of SE treatment to the time until there was no clinical evidence of seizure. Seizure control was defined clinically and/or by EEG. Patient status after treatment was defined by patient's functional capacity at the discharge date from the hospital and categorized as dependent or non-dependent status. The dependent status was defined as a condition that the patients needed someone to assist them daily life activities and equal to modified Rankin scale (mRs) of two or more. Worsening of functional outcome was defined by change of functional outcome to dependent status or death at discharge date. Mortality rate and duration of treatment were recorded.
Baseline characteristics between phenytoin and sodium valproate group were compared by descriptive statistics. All outcome variables were also tested for the differences between those treated with phenytoin and sodium valproate. Wilcoxon rank sum or student t-test and Fisher's exact tests or Chi-square test were applied to compare the differences in numbers and proportions between the two groups where appropriate. The study protocol was approved by the ethics committee on human research of Khon Kaen University (HE541319).
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