Modern approach to intravenous valproate use in epileptic status treatment

Commission on classification and terminology of International League Against Epilepsy defines epileptic status (ES) as a condition that implies a continuous seizure or a series of seizure lasting more than 30 minutes without full recovery of neurological functions in interictal period. It is considered one of the most dangerous life-threatening emergency conditions. ES etiology, timing and adequacy of therapeutic intervention are the main factors that define prognosis. The most frequent cause of ES development in a patient with previously diagnosed epilepsy is a decrease of antiepileptic medication concentration in serum associated with low compliance. ES pharmacotherapy is one of the most challenging issues in acute neurology. ES successful treatment includes the use of the most effective treatment regimen in as short a time as possible with minimal adverse effects. Along with traditionally used medications (benzodiazepines, hydantoins, barbiturates) for convulsive ES treatment injectable forms of valproate (Convulex®) can also be used that is supported by numerous foreign and Russian clinical studies. In a case of symptomatic ES after acute brain injury and coma, non-convulsive ES, and in cases associated with risk of cardiorespiratory function suppression, injectable forms of valproate are used