Valproic acid can reduce the frequency of seizures through various mechanisms and is widely used in clinical practice as a monotherapy or adjunctive treatment for various types of epilepsy and epileptic syndromes. In addition, valproic acid has significant therapeutic effects on comorbidities associated with epilepsy, such as migraines and psychiatric disorders. It can also be effective in terminating status epilepticus and is commonly used as a broad-spectrum antieseizure medication in clinical settings. However, valproic acid has side effects such as teratogenicity, infertility, and menstrual disorders. Additionally, when used in combination with other drugs, the interactions between medications should be carefully considered. Therefore, in clinical practice, it is necessary to strictly adhere to the indications and dosage regimens for the use of valproic acid. This article provides a comprehensive review of the use of valproic acid in different types of seizures, epileptic syndromes, comorbidities associated with epilepsy, post-craniotomy cases, status epilepticus, and special populations. It also summarizes the combination therapy of valproic acid with other drugs, providing a basis for the rational use of valproic acid and individualized drug treatment selection for epilepsy patients.
Objective To investigate the number, distribution and characteristics of the treatment of epilepsy by vagus nerve stimulation (VNS) under China's three-grade diagnosis and treatment system from 2022 to 2023. Methods Researchers from the China Association Against Epilepsy (CAAE) conducted investigations on the number and distribution of epilepsy centers, as well as the number and distribution of VNS treatments for epilepsy from 2022 to 2023 through online and telephone surveys. Results A total of 435 epilepsy centers in China participated in the treatment of epilepsy by VNS under the three-grade system, among which 191 (43.91%) were in the eastern region. From 2022 to 2023, a total of 1 888 VNS procedures were carried out. Among them, 1 255 procedures (66.47%) were carried out in the eastern region; 1 253 procedures (66.37%) were carried out in third-level epilepsy centers, and 635 procedures (33.63%) were carried out in second-level epilepsy centers. Conclusions The promotion and application of VNS for the treatment of epilepsy under China's three-grade diagnosis and treatment system have achieved preliminary outcomes. However, there are still a regional imbalance in the VNS treatment and a shortage of abilities in primary epilepsy c enters.