Efficacy and tolerability of high-dose phenobarbital in children with focal seizures

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• 作者：Akihisa Okumura^a ; ^b ; ^{okumura.akihisa.479@mail.aichi-med-u.ac.jp" class="auth_mail" title="E-mail the corresponding author} ; Eri Nakahara^a ; Mitsuru Ikeno^a ; Shinpei Abe^a ; Ayuko Igarashi^a ; Mika Nakazawa^a ; Michihiko Takasu^a ; ^b ; Toshiaki Shimizu^a
• 关键词：Phenobarbital ; Efficacy ; Tolerability ; Serum level
• 刊名：Brain and Development
• 出版年：2016
• 出版时间：April 2016
• 年：2016
• 卷：38
• 期：4
• 页码：414-418
• 全文大小：174 K

文摘

We retrospectively reviewed the outcomes of children with focal epilepsy treated with oral high-dose phenobarbital.

Methods

We reviewed data on children (aged < 15 years) with focal seizures treated with high-dose phenobarbital (>5 mg/kg/day to maintain a target serum level >40 μg/mL) for at least 6 months. Seizure frequency was evaluated after phenobarbital titration, and 1 and 2 years after high-dose phenobarbital treatment commenced. Treatment was judged effective when seizure frequencies fell by ⩾75%.

Results

Seven boys and eight girls were treated. The median age at commencement of high-dose phenobarbital therapy was 30 months. The maximal serum phenobarbital level ranged from 36.5 to 62.9 μg/mL. High-dose PB was effective in seven. In two patients, treatment was transiently effective, but seizure frequency later returned to the baseline. High-dose PB was ineffective in six. No significant association between effectiveness and any clinical variable was evident. Drowsiness was recorded in nine patients, but no patient developed a behavioral problem or hypersensitivity.

Conclusion

Oral high-dose phenobarbital was effective in 7 of 15 patients with focal epilepsy and well tolerated. High-dose PB may be useful when surgical treatment is difficult.