title: Very high dose phenobarbital for refractory status epilepticus.
abstract: BACKGROUND
  Refractory status epilepticus (RSE), defined as status epilepticus that fails to respond to first, second and third-line therapy. The RSE is associated with high morbidity and mortality. Treatment guidelines of RSE give a spectrum of options, such as, continuous intravenous (i.v.) midazolam (MDL), or continuous i.v. propofol (PRO) as alternatives to phenobarbital (PB) or continuous i.v. pentobarbital (PTB).
  
  
  OBJECTIVE
  To study the efficacy of very-high-dose phenobarbital (VHDPB) for treatment RSE.
  
  
  METHODS
  Retrospective study
  
  
  METHODS
  The authors collected and analyzed data from adult patients who were diagnosed with RSE.
  
  
  RESULTS
  The authors present 10 patients with RSE who were treated with VHDPB. All of them were generalized convulsive status epilepticus (GCSE). Ages ranged from 16-86 years old (mean.: 43 years). PB dosage ranged 40-140 mg/kg/day (mean: 70 mg/kg/day). The duration of status epilepticus (SE) varied widely, ranged 1-44 days (mean: 7 days). PB level ranged 35.29-218.34 ug/mL (mean 88.1 ug/mL). RSE was controlled by VHDPB 70%, 30% were not controlled.
  
  
  CONCLUSIONS
  VHDPB were considered as alternative treatment for RSE.
authors.affiliation: Division of Neurology, Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand. somtia@kku.ac.th
authors.forename: Somsak
authors.initials: S
authors.lastname: Tiamkao
authors.forename: Nattakarn
authors.initials: N
authors.lastname: Mayurasakorn
authors.forename: Panit
authors.initials: P
authors.lastname: Suko
authors.forename: Suthipun
authors.initials: S
authors.lastname: Jitpimolmard
authors.forename: Suwanna
authors.initials: S
authors.lastname: Arunpongpaisal
authors.forename: Warinthorn
authors.initials: W
authors.lastname: Phuttharak
authors.forename: Narong
authors.initials: N
authors.lastname: Auevitchayapat
authors.forename: Suda
authors.initials: S
authors.lastname: Vannaprasaht
authors.forename: Siriporn
authors.initials: S
authors.lastname: Tiamkao
authors.forename: Kutcharin
authors.initials: K
authors.lastname: Phunikhom
authors.forename: Aporanee
authors.initials: A
authors.lastname: Chaiyakum
authors.forename: Jiamjit
authors.initials: J
authors.lastname: Saengsuwan
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010634:Phenobarbital / Q000008:administration & dosage / Q000627:therapeutic use*; D012008:Recurrence; D012189:Retrospective Studies; D013226:Status Epilepticus / Q000188:drug therapy*; D017211:Treatment Failure
chemical_list: D000927:Anticonvulsants; D010634:Phenobarbital