High-dose phenobarbital with intermittent short-acting barbiturates for acute encephalitis with refractory, repetitive partial seizures

Takashi Uchida, Masaru Takayanagi, Taro Kitamura, Toshiyuki Nishio, Yurika Numata, Wakaba Endo, Kazuhiro Haginoya, Toshihiro Ohura

Research output: Contribution to journalArticlepeer-review

2 Citations (Scopus)

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 languageEnglish
Pages (from-to)750-753
Number of pages4
JournalPediatrics International
Volume58
Issue number8
DOIs
Publication statusPublished - 2016 Aug 1
Externally publishedYes

Keywords

  • barbiturates
  • encephalitis
  • febrile seizure
  • partial seizure disorder
  • phenobarbital

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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