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Original ArticleOpen Access
Very High Dose Phenobarbital for Refractory Status Epilepticus
Tiamkao S ,
Mayurasakorn N ,
Mayurasakorn N ,
Suko P ,
Suko P ,
Jitpimolmard S ,
Jitpimolmard S ,
Arunpongpaisal S ,
Arunpongpaisal S ,
Phuttharak W ,
Phuttharak W ,
Auevitchayapat N ,
Auevitchayapat N ,
Vannaprasaht S ,
Vannaprasaht S ,
Tiamkao S ,
Tiamkao S ,
Phunikhom K ,
Phunikhom K ,
Chaiyakum A ,
Chaiyakum A ,
Saengsuwan J ,
Saengsuwan J
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Citation
Tiamkao S, Mayurasakorn N, Mayurasakorn N, Suko P, Suko P, Jitpimolmard S, Jitpimolmard S, et al. Very High Dose Phenobarbital for Refractory Status Epilepticus. J Med Assoc Thai 2007;90:2597.
Background:Refractory status epilepticus (RSE), defined as status epilepticus that fails to respond to first, second and third-line therapy. The RSE is associated with high morbidity and mortality. Treatment guidelines of RSE give a spectrum of options, such as, continuous intravenous (i.v.) midazolam (MDL), or continuous i.v. propofol (PRO) as alternatives to phenobarbital (PB) or continuous i.v. pentobarbital (PTB).
Objective: To study the efficacy of very-high-dose phenobarbital (VHDPB) for treatment RSE.
Study design: Retrospective study.
Material and Method: The authors collected and analyzed data from adult patients who were diagnosed with RSE.
Results: The authors present 10 patients with RSE who were treated with VHDPB. All of them were generalized convulsive status epilepticus (GCSE). Ages ranged from 16-86 years old (mean: 43 years). PB dosage ranged 40-140 mg/kg/day (mean: 70 mg/kg/day). The duration of status epilepticus (SE) varied widely, ranged 1-44 days (mean: 7 days). PB level ranged 35.29-218.34 ug/mL (mean 88.1 ug/mL). RSE was controlled by VHDPB 70%, 30% were not controlled.
Conclusion: VHDPB were considered as alternative treatment for RSE.
Keywords: Refractory status epilepticus, Very high dose phenobarbital, Treatment
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