All issues > Volume 36(3); 1993

Original Article

J Korean Pediatr Soc. 1993;36(3):328-337. Published online March 15, 1993.

A Study of Valproic Acid Therapy in Epileptic Children

Hae Jin HJ Choi¹, Keon Su KS Rhee²

¹Department of Pediatrics, Eul ji Hospital, Tae jon, Korea
²Department of Pediatrics, Chungnam National University College of Medicine Taejon, Korea

Abstract

A study was made on 50 cases of epileptic children who had been observed at the pediatric department of Chungnam National University Hospital and Taejeon Eul Ji Hospital during the period from July, 1986 to June, 1991 The result are as follows : 1) Epilepsy was most frequent in children from 1 yar to 10 year of age(80%). Epilepsy was commoner in female children compare to male representing male to female ratio, 1:1.2 2) Intractable cases with VPA were 40%, and male to female ratio was 1.2:1. Intractable cases were most common between 1 and 5 years(65%). 3) The most common epileptic type was generalized tonic clonic seizure(38%). 4) The clinical effect of valproic acid was the worst in severely abnormal EEG finding 5) The mean plasma VPA level was significantly lower for the polytherapy(57.7㎍/ml)than for the monotherapy(69.5㎍/ml). The VPA does of steady-state was significantly higher for the polytherapy(27.9mg/kg/d) than for the monotherapy(20.9mg/kg/d). VPA level : dose ratio was reduced in the polytherapy(2.1)as compared to monotherapy(3.3) 6) The plasma VPA level increased according to dosage. In the same dose, plasma level of monotherapy was significantly higher than polytherapy. 7) The VPA dose of stead-state was the highest under 1 year(monotherapy:24.8mg/kg/day, polytherapy:33.4mg/kg/day). The VPA dose decreased in accordance with increase of the age. 8) There was no correlation between EEG change and plasma concentration of VPA 9) There was linear correlation between clinical affect and plasma VPA level, and plasma concentration of VPA reached 51 to 100ug/ml at that time. 10) The clinical effect was good in abscence seizure, simple partial seizure, myoclonic seizure, and generalized tonic clonic seizure in decreasing order. 11) The incidence of side effect were gastrointestinal disturbance, behavior disorder, laboratory abnormality, neurologic abnormality in order of frequency. The frequency of overall side effects observed was 40%, but toxic effects were generally mild.

Keywords :Valproic acid, Epilepsy