A COMMENT ON THE EFFICACY OF VALPROATE IN THE TREATMENT OF PARTIAL SEIZURES

Discrepancies in the findings of studies sponsored by the Department o f Veterans Affairs (VA) in the United States and the Medical Research Council (MRC) in the United Kingdom concerning the efficacy of valproa te (VPA) in controlling simple or complex partial seizures, particular ly those without secondarily generalized seizures, were reviewed. It w as noted that the two studies differed with respect to their subjects' pretreatment seizure frequency. The frequency of complex partial seiz ures before treatment was obviously greater in the VA study, where car bamazepine (CBZ) provided better seizure control than VPA. Based on ot her comparative and non-comparative studies as well as the author's ov er 20 years of experience in the use of VPA in a tertiary epilepsy cli nic, it is suggested that although VPA may be effective in controlling both the secondarily generalized seizures of symptomatic localization -related epilepsies and the generalized tonic-clonic seizures of idiop athic and, if not always. symptomatic generalized epilepsies, the effi cacy of VPA in controlling simple or complex partial seizures is likel y limited to patients with infrequent seizures.