Comparative Analysis between Valproate and Phenytoin in Convulsive Status Epilepticus in Pediatric Population

Introduction: Status epilepticus (SE) is a common neurological emergency in children that calls for prompt and aggressive treatment and occasionally presents a therapeutic challenge to the attending physician. The main anti-epileptic impact is brought about by voltage-dependent sodium channels being inhibited. Phenytoin reduces sodium input into neurons, which reduces excitability, by acting on the intracellular portion of the ion channel. Since action depends on both use and concentration, it should start as soon as an effective concentration is attained. The most frequent neurologic emergency, generalized convulsive status epilepticus (GCSE), accounts for 1% to 2% of all visits to the emergency room. Any seizure lasting more than 30 minutes is considered to be in the status epilepticus (SE), regardless of whether awareness is affected or whether subsequent seizures occur without a break in consciousness. Aims and Objectives: To compare the efficacy between valproate and phenytoin during status epilepticus among children. Methods: A randomized double-controlled study was conducted on 100 pediatric patients who visited the outpatient department. Injections of sodium valproate (Valprol, 5 mL per 500 mg, Intas Pharmaceuticals, India), and sodium phenytoin (Ciroton, 2 mL per 100 mg, Ciron Pharmaceuticals, India) were used. The baseline characteristics were determined before the drug treatment and the outcome assessment factors were assessed after the drug treatment of each group at prescribed dosage and duration. required statistical analysis was conducted. Results: The patients were divided equally into 2 groups phenytoin and valproate. Males are more in valproate group (60%). Generalized convulsive seizure are mostly seen in valproate group (90%) compared to phenytoin group (76%). Hypocalcemia is seen mostly in phenytoin (12%) than valproate (10%). The primary outcome is seen in 90% of phenytoin group and 82% in valproate group. The phenytoin group had a greater rate of additional medicine to control the seizure after control of the seizure by study drug (21.3%) compared to the valproate group (11.6%). Conclusion: This study has demonstrated that phenytoin and valproate are equally effective in reducing seizure frequency in the treatment of paediatric convulsive status epilepticus