[Evaluation of the efficacy of phenobarbital in treatment of epilepsy in rural areas: study of 2455 patients in rural China].
OBJECTIVE
To evaluate the efficacy of phenobarbital in treatment of patients with convulsive forms of epilepsy in rural areas and to develop a suitable relevant model for rural China.


METHODS
A demonstration protocol was conducted in the rural areas of 8 counties from 6 provinces and municipality in China, Heilongjiang, Ningxia, Henan, Jiangsu, Shanxi, and Shanghai from December 2001 to June 2004. Epidemiological investigation of the prevalence and treatment gap of epilepsy was carried out. Patients with convulsive forms of epilepsy thus screened underwent treatment of phenobarbital. Physicians of township hospitals received short-term training to be in charge of the treatment and regular follow-up of the patients.


RESULTS
A total of 2455 patients with generalized tonic-clonic seizures in these 6 rural areas were screened and entered the treatment group. 347 patients (26.2%) had been seizure-free during the period of these 2 years, 415 patients (31.3%) had their seizure frequencies decreased by > 75% as compared with those during the period of 6 months before treatment, and the conditions of 26.1% of the patients did not change or even became worse. About 26.1% of the patients had mild side effects, 3.7% had moderate side effects, and only 0.3% had severe side effects when the dosage of phenobarbital in the first 3 months was increased. 597 patients (24.3%) withdrew from the treatment group because of various reasons.


CONCLUSIONS
This protocol was suitable to the rural areas of China. The trained physicians are capable of fulfilling the task to treat the patients with epilepsy. Phenobarbital is an effective drug for most patients with convulsive seizures and has no severe side effect.
Wang
Wen-zhi
WZ
Beijing Neurosurgical Institute, 100050 Beijing, China.
Wu
Jian-zhong
JZ
Dai
Xiu-ying
XY
Wang
Tai-ping
TP
Yang
Bin
B
Ma
Guang-yu
GY
Yuan
Cheng-lin
CL
Hong
Zhen
Z
Zhao
Dong-hai
DH
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D002681:China / Q000453:epidemiology; D004827:Epilepsy / Q000188:drug therapy* / Q000453:epidemiology; D005260:Female; D005500:Follow-Up Studies; D006780:Hospitals, Rural; D006801:Humans; D008297:Male; D008875:Middle Aged; D010634:Phenobarbital / Q000627:therapeutic use*; D012423:Rural Health; D016896:Treatment Outcome
D000927:Anticonvulsants; D010634:Phenobarbital