Oral high-dose phenobarbital therapy for early infantile epileptic encephalopathy.
We report oral high-dose phenobarbital therapy for a patient with early infantile epileptic encephalopathy with suppression bursts (Ohtahara syndrome). At 1 month of age, many series of tonic spasms, with raising limbs and crying lasting for a few minutes, developed and increased up to approximately 300 times per day. Initially intravenous midazolam (0.5 mg/kg/hour) slightly decreased the seizures, although oral vitamin B6, valproic acid, clonazepam, and zonisamide had little effect. Oral high-dose phenobarbital therapy was begun at a dosage of 15 mg/kg/day, and the seizures markedly decreased to 5-10 times per day and the epileptic discharges on electroencephalogram greatly decreased. Serum phenobarbital levels ranged between 60 and 100 mg/dL. High-dose phenobarbital therapy should be considered for the treatment of early infantile epileptic encephalopathy with suppression bursts.
Ozawa
Hiroshi
H
Department of Pediatrics, Tokyo Metropolitan Hachioji Children's Hospital, Hachioji, Tokyo, Japan.
Kawada
Yuko
Y
Noma
Seiji
S
Sugai
Kenji
K
D000284:Administration, Oral; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D004305:Dose-Response Relationship, Drug; D004569:Electroencephalography; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D010634:Phenobarbital / Q000008:administration & dosage* / Q000097:blood / Q000627:therapeutic use; D013036:Spasms, Infantile / Q000188:drug therapy* / Q000503:physiopathology
D000927:Anticonvulsants; D010634:Phenobarbital