title: Very-high-dose phenobarbital for childhood refractory status epilepticus.
abstract: This report describes the management of three children, ranging in age from 7 to 9 years, who had refractory status epilepticus. This condition was likely the result of viral encephalitis; it manifested initially as generalized tonic-clonic seizure and later frequent subtle eye staring and twitching of mouth or limbs as well as tachycardia and dilatation of pupils. The seizures were not responsive to treatment with conventional doses of intravenous phenobarbital, phenytoin, and midazolam infusion. Very-high-dose phenobarbital was administered at accumulated daily doses up to 80 mg/kg, with a resulting serum level of more than 1000 mumol/L. It was effective in achieving seizure control, with milder adverse effects compared with thiopental infusion.
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region, China. jleewk@hotmail.com
authors.forename: Wai Kin
authors.initials: WK
authors.lastname: Lee
authors.forename: Kam Tim
authors.initials: KT
authors.lastname: Liu
authors.forename: Betty Wan Yin
authors.initials: BW
authors.lastname: Young
mesh_terms: D000927:Anticonvulsants / Q000008:administration & dosage*; D002648:Child; D004305:Dose-Response Relationship, Drug; D004359:Drug Therapy, Combination; D004569:Electroencephalography; D006801:Humans; D008297:Male; D010634:Phenobarbital / Q000008:administration & dosage*; D013226:Status Epilepticus / Q000188:drug therapy* / Q000503:physiopathology
chemical_list: D000927:Anticonvulsants; D010634:Phenobarbital