ĐÁNH GIÁ HIỆU QUẢ VÀ AN TOÀN CỦA VALPROATE TRUYỀN TĨNH MẠCH TRONG TRẠNG THÁI ĐỘNG KINH CO CỨNG - CO GIẬT TẠI BỆNH VIỆN NHÂN DÂN 115

Abstract

Objective: To develop and implement an intravenous valproate treatment protocol for convulsive status epilepticus (CSE) at People’s Hospital 115. Methods: A prospective case series study was conducted on five patients diagnosed with generalized convulsive status epilepticus according to the criteria of the International League Against Epilepsy (ILAE)⁵, who did not respond to first-line treatment with slow intravenous benzodiazepines and subsequently received second-line treatment with intravenous valproate. The study was carried out at the Department of General Neurology, 115 People's Hospital, from March 2025 to July 2025. Results: The intravenous valproate treatment protocol for generalized convulsive status epilepticus was developed with the following steps: assessment of indications and contraindications, determination of loading dose, drug preparation, monitoring during infusion, and post-infusion observation. The protocol was applied to five patients with generalized convulsive status epilepticus who did not respond to first-line treatment with slow intravenous midazolam. As a result, 2 out of 5 patients achieved complete seizure cessation after the loading dose, while 3 patients proceeded to step 3 with continuous intravenous midazolam infusion. No serious adverse effects were observed. Conclusion: The intravenous valproate treatment protocol for generalized convulsive status epilepticus demonstrates feasibility, effectiveness, and safety, contributing to a shortened time to seizure control. Given its availability in Vietnam, intravenous valproate should be considered a priority second-line treatment option for patients with generalized convulsive status epilepticus who do not respond to first-line intravenous benzodiazepines