[Clinical study of pentobarbital treatment for status convulsivus in 14 children].
We reviewed factors affecting the efficacy of pentobarbital (PTB) therapy for status convulsivus refractory to diazepam, phenytoin and other. The subjects were fourteen children (six boys and eight girls aged from 4 months to 11 years old) with status convulsivus admitted to Niigata City General Hospital, from April 1986 to August 1992. Nine children had status convulsivus secondary to encephalitis or encephalopathy. The other five had status convulsivus associated with epilepsy. The effectiveness of the PTB therapy was defined as follows: 1) Excellent, seizures ceased without recurrence. 2) Effective, seizures ceased but recurred with a decreased dose of PTB. 3) Ineffective, seizures continued so other drugs were necessary, or the patient died. We divided the patients into two groups, encephalitis and encephalopathy, and epilepsy. We estimated the efficacy of PTB in each group. In the encephalitis and encephalopathy group, the effectiveness of PTB was excellent in 2, effective in 2, and ineffective in 3. In the excellent cases there was a tendency that the duration of status convulsivus before the PTB therapy was shorter and the loading dose of PTB was greater. In the epilepsy group, in four cases PTB was effective, and in one ineffective, thus the effectiveness of PTB was relatively good. There was no factor that directly affected the efficacy of PTB therapy, but patients who required a rapid rate of infusion of PTB needed PTB therapy for a longer time. These findings indicate that PTB therapy should be started as soon as possible in cases of refractory status convulsivus due to encephalitis or encephalopathy.
Kobayashi
K
K
Department of Pediatrics, Niigata City General Hospital.
Watanabe
T
T
Sato
M
M
D002648:Child; D002675:Child, Preschool; D004660:Encephalitis / Q000150:complications; D004827:Epilepsy / Q000150:complications; D005260:Female; D006801:Humans; D006993:Hypnotics and Sedatives / Q000008:administration & dosage*; D007223:Infant; D008297:Male; D010424:Pentobarbital / Q000008:administration & dosage*; D012640:Seizures / Q000188:drug therapy* / Q000209:etiology
D006993:Hypnotics and Sedatives; D010424:Pentobarbital