:Comparison between Primary and Secondary Generalized Epilepsies

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Treatment with sodium valproate (VPA) alone was undertaken in children with epilepsy of the convulsive type, in particular, tonic-clonic seizures, and the comparative efficacy of VPA in primary versus secondary generalized epilepsies in terms of seizure control and electroencephalographic improvement was studied. 1. Complete seizure control was achieved in 23 out of 33 primary (70%), while in 5 out of 15 secondary cases (33.3%). 2. Between the effects and the time lag of starting medication after the onset, no significant relation was found. 3. The effectiveness of VPA on paroxysmal EEG abnormalities was found to be marked in 8 and moderate in 4 among 17 cases of the primary group. Among 13 cases of the secondary group, marked and moderate improvements were noticed only in three and one, respectively, while in other nine (69.2%) EEG did not changed at all or even worsened. However, the difference between the two groups was not significant. 4. Electroencephalographically, the effect of VPA most prominently manifested against diffuse paroxysmal discharges, while it was poor against unilateral focal paroxysmal discharges. 5. In a few cases, a complete control of seizures was attained with serum VPA concentration of less than 40 μg/ml.
一般社団法人日本小児神経学会の論文