title: [Efficacy of intravenous phenobarbital treatment for status epilepticus].
abstract: OBJECTIVE
  Intravenous phenobarbital (IV-PB) therapy was launched in Japan in October 2008. We retrospectively investigated its efficacy and tolerability in patients with status epilepticus.
  
  
  METHODS
  Forty-three consecutive patients received IV-PB for status epilepticus between June 2009 and April 2011. Among them, 39 patients had underlying diseases, which included acute diseases in 19 patients and chronic conditions in 20 patients. Although 18 patients had been taking antiepileptic drugs (AEDs) before the occurrence of status epilepticus, the blood AED concentrations in 8 patients was below the therapeutic levels. Before the administration of IV-PB, 39 patients were treated with intravenous benzodiazepine, 17 patients were treated with intravenous phenytoin, and 15 patients with intravenous infusion of lidocaine.
  
  
  RESULTS
  The initial doses of IV-PB ranged from 125 to 1,250 mg (1.9-20.0 mg/kg). Additional doses of IV-PB were required in 12 patients. Seizures were controlled in 35 patients (81%) after IV-PB administration. Cessation of status epilepticus was attained in 24 patients after the initial dose and in 11 patients after additional doses. There were no serious adverse effects, although respiratory suppression was observed in 3 patients and drug eruption was observed in 1 patient.
  
  
  CONCLUSIONS
  IV-PB is relatively safe and effective for controlling status epilepticus. If the first dose is not effective, additional doses are required up to the recommended maximum dose.
authors.affiliation: Department of Neurosurgery, Nakamura Memorial Hospital.
authors.forename: Emiko
authors.initials: E
authors.lastname: Muramoto
authors.forename: Masahiro
authors.initials: M
authors.lastname: Mizobuchi
authors.forename: Yoshihiro
authors.initials: Y
authors.lastname: Sumi
authors.forename: Kazuya
authors.initials: K
authors.lastname: Sako
authors.forename: Atsuko
authors.initials: A
authors.lastname: Nihira
authors.forename: Akiko
authors.initials: A
authors.lastname: Takeuchi
authors.forename: Hirohiko
authors.initials: H
authors.lastname: Nakamura
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000927:Anticonvulsants / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D010634:Phenobarbital / Q000008:administration & dosage / Q000009:adverse effects / Q000097:blood / Q000627:therapeutic use*; D013226:Status Epilepticus / Q000188:drug therapy* / Q000453:epidemiology; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000927:Anticonvulsants; D010634:Phenobarbital