title: Lack of efficacy of phenytoin in children presenting with febrile status epilepticus.
abstract: BACKGROUND
  Fever is the most common precipitant of status epilepticus in children. Animal models suggest that only γ-aminobutyric acidic drugs are effective in the treatment of febrile seizures, but there is limited clinical evidence to support this.
  
  
  OBJECTIVE
  The aim of this study was to determine the efficacy of phenytoin, a sodium channel blocker, in the treatment of febrile status epilepticus in children.
  
  
  METHODS
  This study is a retrospective chart review of 56 children (62 episodes) who presented to our emergency department with febrile status epilepticus and received phenytoin. The clinical parameters were evaluated by reviewing the charts. The efficacy of phenytoin was classified into 3 categories: positive, negative, and nonevaluable response.
  
  
  RESULTS
  The primary outcome was to evaluate the efficacy rate of phenytoin; there were 9 (14.5%) of 62 episodes with a positive response, 25 (40.3%) with a negative response, and 28 (45.2%) with a nonevaluable response because phenytoin was given simultaneously with a γ-aminobutyric acidic (GABAergic) drug (P < .001). The secondary outcome was to measure the mean seizure duration for each treatment category, which were 52.8, 109.9, and 52.6 minutes, respectively (P < .01).
  
  
  CONCLUSIONS
  Phenytoin is rarely effective in controlling febrile status epilepticus. Children exposed to phenytoin have more prolonged febrile seizures, increasing the risk of brain injury.
authors.affiliation: Department of Pediatrics, Division of Neurology, CHU Saint-Justine, University of Montreal, Montreal, Canada.
authors.forename: Salima
authors.initials: S
authors.lastname: Ismail
authors.forename: Arielle
authors.initials: A
authors.lastname: Lévy
authors.forename: Helena
authors.initials: H
authors.lastname: Tikkanen
authors.forename: Marcel
authors.initials: M
authors.lastname: Sévère
authors.forename: Franciscus Johannes
authors.initials: FJ
authors.lastname: Wolters
authors.forename: Lionel
authors.initials: L
authors.lastname: Carmant
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D004636:Emergency Service, Hospital; D006801:Humans; D007223:Infant; D008297:Male; D010672:Phenytoin / Q000627:therapeutic use*; D012189:Retrospective Studies; D003294:Seizures, Febrile / Q000188:drug therapy*; D013226:Status Epilepticus / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin