A valproat helye az epilepszia és a status epilepticus kezelésében

Translated title of the contribution: Valproate in the treatment of epilepsy and status epilepticus

J. Janszky, Dalma Tényi, Beata Bóné

Research output: Contribution to journalReview article

Abstract

According to Hungarian guidelines, valproate - with the exception of infants and small children as well as fertile women - is the first drug of choice in generalized and unclassified epilepsies because it is effective in most seizure types and epilepsy syndromes. It is highly effective in juvenile myoclonic epilepsy. Even though it is not the first-line drug in focal epilepsies, if the first-line therapy is ineffective, it is a plausible alternative as second choice therapy, owing to its different mechanism of action. If the type of epilepsy can't be surely established, valproate is the drug of choice, as it possesses the broadest-spectrum among antiepileptic drugs. After administration of benzodiazepines, intravenously applied valproate can be a first choice therapy in all types of status epilepticus, owing to its broad-spectrum and efficacy. Valproate is the first-choice therapy in patients with glioblastoma - independently of the seizure type-, as it is likely to improve the survival rate with 2-10 months and the effedivi-ty of chemo- and radiotherapy. Valproate is generally not suggested for fertile women, but - as it is the most effective therapy in some epilepsy syndromes-, the patient has the right to choose valproate therapy, thus undertaking the elevated risk of developmental abnormalities, for higher safety regarding seizures. If only valproate therapy owns the ability to obtain seizure freedom, then stopping its administration is not suggested, but a low dosage has to be aimed (500-600 mg/day, but not more than 1000 mg/day): according to some studies, most idiopathic generalized epilepsies can be controlled by low valproate dosage. Stopping valproate therapy in case of an ongoing pregnancy is not suggested.

Original languageHungarian
Pages (from-to)258-264
Number of pages7
JournalIdeggyogyaszati Szemle
Volume70
Issue number7-8
DOIs
Publication statusPublished - Jul 30 2017

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ASJC Scopus subject areas

  • Neurology
  • Clinical Neurology

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