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Efficacy and Tolerability of Intravenous Valproic
Acid in Acute Adolescent Migraine
Pamela Reiter, Jason Nickisch, Glenn Merritt
Posted: December 2005
Objective: To describe the efficacy and
tolerability of rapid intravenous valproic acid (VPA) infusions in
children with severe migraine headache.
Background: Intravenous VPA is an emerging treatment
option for acute migraine headache. Adult data suggests both
efficacy and tolerability of rapid VPA infusions a abortive therapy,
but little data exist in children.
Methods: We conducted a retrospective chart review of
all children who received intravenous VPA at The Childrenís Hospital
Headache Clinic during an 18-month study period. Baseline intensity
of headache pain, time at which maximum relief was attained, pain
reduction following therapy, dose and duration of VPA infusion(s),
patientís pulse, blood pressure, respiratory rate, and pulse
oximetry were collected. Adverse events were also recorded.
Results: Thirty-one children requiring 58 clinic
visits and 71 VPS infusions were included. Most visits resulted
in only one dose of VPA for desired pain relief. Some children
required a second dose. VPS infusions were well tolerated.
Adverse events described included cold sensation, dizziness,
nausea, possible absence seizure, paraesthesia, and tachycardia.
Conclusions: Rapid infusion of intravenous VPA is
generally well tolerated and may play a role in the management of
children with acute migraine headache. Prospective, controlled
trials to further investigate this treatment in children are