[Successful induction of tolerance in an epilepsy patient with phenobarbital allergy].
We report on a 32-year-old female patient who had had a history of complex partial seizures since the age of 14. Phenobarbital was the most effective anticonvulsant drug in this patient. However, the drug treatment was complicated by a phenobarbital-induced exanthematous eruption. Reintroduction of the phenobarbital some years later resulted in a skin rash again; therefore, treatment with this substance had to be discontinued a second time. Because of the satisfactory antiepileptic efficacy, phenobarbital was introduced a third time using a desensitization procedure with increased oral doses, starting with a dose of 1 mg. After a daily dose of 90 mg phenobarbital, on day 6 an exanthematous eruption appeared. The exanthem disappeared parallel to a dose reduction of phenobarbital and with a gradually increasing dosage up to a maintenance dose of 200 mg. Tolerance to the allergic effect of phenobarbital was preserved and the seizure frequency was significantly reduced by phenobarbital monotherapy with a daily dose of 200-175 mg.
Fröscher
W
W
Abteilung für Neurologie und Epileptologie, Die Weissenau, Universität Ulm, Ravensburg-Weissenau.
Kleinhans
D
D
D000328:Adult; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*; D003888:Desensitization, Immunologic; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D003875:Drug Eruptions / Q000276:immunology* / Q000628:therapy; D017029:Epilepsy, Complex Partial / Q000188:drug therapy* / Q000276:immunology; D005260:Female; D006801:Humans; D007108:Immune Tolerance / Q000276:immunology; D010634:Phenobarbital / Q000008:administration & dosage / Q000009:adverse effects / Q000276:immunology*
D000927:Anticonvulsants; D010634:Phenobarbital