title: [A case of acute encephalitis with refractory repetitive partial seizures successfully controlled by very-high-dose phenobarbital therapy found in a boy].
abstract: We experienced a case of acute encephalitis with refractory, repetitive partial seizures (AERRPS) found in an 8-year-old boy. Convulsive status epilepticus developed at the onset, which was intractable to the treatment with intravenous thiopental sodium even at the maximum dose of 9 mg/kg/hr. Since the adverse effect developed, thiopental sodium was discontinued. Phenobarbital (PB) was administrated at a very high daily dose up to 80 mg/kg, reaching serum trough level of 250 μg/ml, which was markedly effective to the treatment. Because seizures reappeared during tapering the dosage of PB, potassium bromide (KBr) at a daily dose of 80 mg/kg was additionally administrated. PB was successfully tapered into a daily dose of 20 mg/kg with a trough serum level around 80 μg/ml. He recovered in motor functions, but had disturbance of memory and apneic seizures. A very-high-dose PB therapy in an early period may be helpful for the treatment of intractable convulsive status epilepticus.
authors.affiliation: Department of Pediatrics, Shizuoka Children's, Hospital. seiji6w-sk@umin.ac.jp
authors.forename: Seiji
authors.initials: S
authors.lastname: Watanabe
authors.forename: Yoshinori
authors.initials: Y
authors.lastname: Okumura
authors.forename: Hideo
authors.initials: H
authors.lastname: Aiba
mesh_terms: D000208:Acute Disease; D002648:Child; D004660:Encephalitis / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D006801:Humans; D008297:Male; D010634:Phenobarbital / Q000008:administration & dosage / Q000627:therapeutic use*; D012640:Seizures / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D013226:Status Epilepticus / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D010634:Phenobarbital