大剂量苯巴比妥口服治疗儿童期难治性癫痫17例临床观察

【目的】评价大剂量苯巴比妥（PB）口服治疗儿童期难治性部分癫痫的有效性及安全性。【方法】回顾17例儿童期难治性部分癫痫患者的医学记录，其中15例为部分性发作，2例继发全面性发作。这些患者予以了PB口服给药，开始剂量为20～30mg／（kg·d），逐渐减少到维持量5～10mg／（kg·d）。在第14天评价此方案的有效性及安全性。【结果】17例患者中的10例（59％），癫痫频率下降超过50％，其中4例停止了发作。7例持续地西泮静脉治疗患者中的5例终止了静脉治疗。7例患者出现了副反应，其中5例可以继续高剂量治疗，因其副反应为一过性，或减量后明显恢复。2例患者因出现Stevens—Johnson综合征放弃了治疗。所有患者没有出现呼吸抑制和低血压。【结论】大剂量的PB口服治疗儿童期难治性癫痫安全、有效。

Clinical Observation of the Effectiveness and Safety of Non-intravenous High-dose Phenobarbital for the q[keatment of Intractable Partial Epilepsy in Childhood

Objective]To evaluate the effectiveness and safety of non-intravenous high-dose Phenobarbital （PB） for the treatment of intractable partial epilepsy in childhood. Methods]Medical records of 17 patients with intractable partial epilepsies in childhood were reviewed. Among them, 15 patients were partial seizures and 2 pa- tients were secondary generalized seizures. All patients were given oral PB with the initial dose of 20-30 mg/（kg·d）, and then PB dosage was gradually reduced to a maintenance dosage of 5-10 mg/（kg·d）. The effectiveness and safety of the schedule were evaluated at 14 days. Results]The seizure frequencies of 10 cases in 17 cases （59%） decreased by more than 50%. Seizure free was found in 4 cases. Intravenous therapy ceased in 5 cases of 7 cases treated with continuous intravenous diazepam. Among 7 cases with side reaction, 5 cases could receive high-dose PB therapy continuously, and recovered obviously after the decrease of the dose because the side reaction was transient. Two cases with Stevens-Johnson syndrome abandoned the therapy. No one had respiratory depression and hypotension. Conclusion] Non-intravenous high-dose PB therapy is effective and safe, and can be considered as an adjuvant treatment for intractable partial epilepsy in childhood.