Abstract
Acute encephalitis with refractory, repetitive partial seizures (AERRPS) is characterized by repetitive seizures during the acute and chronic phases and has a poor neurological outcome. Burst-suppression coma via continuous i.v. infusion of a short-acting barbiturate is used to terminate refractory seizures, but the severe side-effects of short-acting barbiturates are problematic. We report on a 9-year-old boy with AERRPS who was effectively treated with very-high-dose phenobarbital (VHDPB) combined with intermittent short-acting barbiturates. VHDPB side-effects were mild, especially compared with those associated with continuous i.v. infusion of short-acting barbiturates (dosage, 40–75 mg/kg/day; maximum blood level, 290 μg/mL). Using VHDPB as the main treatment, short-acting barbiturates were used intermittently and in small amounts. This is the first report to show that VHDPB, combined with intermittent short-acting barbiturates, can effectively treat AERRPS. After treatment, convulsions were suppressed and daily life continued, but intellectual impairment and high-level dysfunction remained.
Original language | English |
---|---|
Pages (from-to) | 750-753 |
Number of pages | 4 |
Journal | Pediatrics International |
Volume | 58 |
Issue number | 8 |
DOIs | |
Publication status | Published - 2016 Aug 1 |
Externally published | Yes |
Keywords
- barbiturates
- encephalitis
- febrile seizure
- partial seizure disorder
- phenobarbital
ASJC Scopus subject areas
- Pediatrics, Perinatology, and Child Health