title: Efficacy and safety of fosphenytoin for acute encephalopathy in children.
abstract: OBJECTIVE
  To evaluate the efficacy and safety of fosphenytoin (fPHT) for the treatment of seizures in children with acute encephalopathy.
  
  
  METHODS
  Using responses from physicians on the Annual Zao Conference on Pediatric Neurology mailing list we chose patients who met the following criteria: clinical diagnosis of acute encephalopathy and use of intravenous fPHT for the treatment of seizures. We divided the patients into two groups: acute encephalopathy with biphasic seizures and late reduced diffusion (AESD) and other encephalopathies. The efficacy of fPHT was considered effective when a cessation of seizures was achieved.
  
  
  RESULTS
  Data of 38 children were obtained (median age, 27 months). Eighteen children were categorized into the AESD group and 20 into the other encephalopathies group. fPHT was administered in 48 clinical events. The median loading dose of fPHT was 22.5 mg/kg and was effective in 34 of 48 (71%) events. The rate of events in which fPHT was effective did not differ according to the presence or absence of prior antiepileptic treatment, subtype of acute encephalopathy, or the type of seizures. One patient experienced apnea and oral dyskinesia as adverse effects of fPHT, whereas arrhythmia, hypotension, obvious reduction of consciousness, local irritation, phlebitis and purple grove syndrome were not observed in any patient.
  
  
  CONCLUSIONS
  fPHT is effective and well tolerated among children with acute encephalopathy.
authors.affiliation: Department of Pediatrics, Juntendo University Faculty of Medicine, Japan; Department of Pediatrics, Juntendo University Nerima Hospital, Japan. Electronic address: mknakaza@juntendo.ac.jp.
authors.forename: Mika
authors.initials: M
authors.lastname: Nakazawa
authors.affiliation: Department of Pediatrics, Iwate Medical University Faculty of Medicine, Japan.
authors.forename: Manami
authors.initials: M
authors.lastname: Akasaka
authors.affiliation: Department of Pediatrics, Soka Municipal Hospital, Japan.
authors.forename: Takeshi
authors.initials: T
authors.lastname: Hasegawa
authors.affiliation: Department of Pediatrics, Kawaguchi Municipal Medical Center, Japan.
authors.forename: Tomonori
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Pediatrics, Juntendo University Faculty of Medicine, Japan; Department of Neuropediatrics, Nagano Children's Hospital, Japan.
authors.forename: Taiki
authors.initials: T
authors.lastname: Shima
authors.affiliation: Department of Pediatrics, Kameda Medical Center, Japan.
authors.forename: Jun-Ichi
authors.initials: J
authors.lastname: Takanashi
authors.affiliation: Department of Pediatrics, Tsuchiura Kyodo General Hospital, Japan.
authors.forename: Atsuko
authors.initials: A
authors.lastname: Yamamoto
authors.affiliation: Department of Pediatrics, St. Mary's Hospital, Japan.
authors.forename: Yuuki
authors.initials: Y
authors.lastname: Ishidou
authors.affiliation: Division of Neurology, Saitama Children's Medical Center, Japan.
authors.forename: Kenjiro
authors.initials: K
authors.lastname: Kikuchi
authors.affiliation: Department of Pediatrics, Juntendo University Nerima Hospital, Japan.
authors.forename: Shinichi
authors.initials: S
authors.lastname: Niijima
authors.affiliation: Department of Pediatrics, Juntendo University Faculty of Medicine, Japan.
authors.forename: Toshiaki
authors.initials: T
authors.lastname: Shimizu
authors.affiliation: Department of Pediatrics, Juntendo University Faculty of Medicine, Japan; Department of Pediatrics, Aichi Medical University, Japan.
authors.forename: Akihisa
authors.initials: A
authors.lastname: Okumura
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D001927:Brain Diseases / Q000503:physiopathology*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010672:Phenytoin / Q000009:adverse effects / Q000031:analogs & derivatives* / Q000627:therapeutic use; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D010672:Phenytoin; C043114:fosphenytoin
keywords: Acute encephalopathy; Acute encephalopathy with biphasic seizures and late reduced diffusion; Efficacy; Fosphenytoin; Safety