Intravenous use of valproic acid in status epilepticus is associated with high risk of hyperammonemia


Status epilepticus (SE) is a neurological emergency with significant morbidity and mortality [1] and requires immediate treatment. In 2012 a committee from the Neurocritical Care Society published expert consensus guidelines [2], but there is a severe lack of double-blinded randomized controlled studies of the treatment of SE. Experts agree that benzodiazepines should be the agent of choice for emergent initial treatment [2]. Phenytoin, lorazepam and phenobarbital have been extensively used for this indication for many years, based largely on the evidence derived from the Veterans Affairs Cooperative Trial [3].


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