Efficacy and tolerability of high-dose phenobarbital in children with focal seizures.
OBJECTIVE
We retrospectively reviewed the outcomes of children with focal epilepsy treated with oral high-dose phenobarbital.


METHODS
We reviewed data on children (aged<15 years) with focal seizures treated with high-dose phenobarbital (>5 mg/kg/day to maintain a target serum level >40 μg/mL) for at least 6 months. Seizure frequency was evaluated after phenobarbital titration, and 1 and 2 years after high-dose phenobarbital treatment commenced. Treatment was judged effective when seizure frequencies fell by ⩾75%.


RESULTS
Seven boys and eight girls were treated. The median age at commencement of high-dose phenobarbital therapy was 30 months. The maximal serum phenobarbital level ranged from 36.5 to 62.9 μg/mL. High-dose PB was effective in seven. In two patients, treatment was transiently effective, but seizure frequency later returned to the baseline. High-dose PB was ineffective in six. No significant association between effectiveness and any clinical variable was evident. Drowsiness was recorded in nine patients, but no patient developed a behavioral problem or hypersensitivity.


CONCLUSIONS
Oral high-dose phenobarbital was effective in 7 of 15 patients with focal epilepsy and well tolerated. High-dose PB may be useful when surgical treatment is difficult.
Department of Pediatrics, Aichi Medical University, Japan; Department of Pediatrics, Juntendo University Faculty of Medicine, Japan. Electronic address: okumura.akihisa.479@mail.aichi-med-u.ac.jp.
Akihisa
A
Okumura
Department of Pediatrics, Aichi Medical University, Japan.
Eri
E
Nakahara
Department of Pediatrics, Aichi Medical University, Japan.
Mitsuru
M
Ikeno
Department of Pediatrics, Aichi Medical University, Japan.
Shinpei
S
Abe
Department of Pediatrics, Aichi Medical University, Japan.
Ayuko
A
Igarashi
Department of Pediatrics, Aichi Medical University, Japan.
Mika
M
Nakazawa
Department of Pediatrics, Aichi Medical University, Japan; Department of Pediatrics, Juntendo University Faculty of Medicine, Japan.
Michihiko
M
Takasu
Department of Pediatrics, Aichi Medical University, Japan.
Toshiaki
T
Shimizu
D000927:Anticonvulsants / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D010634:Phenobarbital / Q000009:adverse effects / Q000627:therapeutic use*; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy*; D016896:Treatment Outcome
D000927:Anticonvulsants; D010634:Phenobarbital
Efficacy; Phenobarbital; Serum level; Tolerability