Very-high-dose phenobarbital for childhood refractory status epilepticus.
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.
Lee
Wai Kin
WK
Department of Paediatrics and Adolescent Medicine, Pamela Youde Nethersole Eastern Hospital, Hong Kong Special Administrative Region, China. jleewk@hotmail.com
Liu
Kam Tim
KT
Young
Betty Wan Yin
BW
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
D000927:Anticonvulsants; D010634:Phenobarbital