Neuropediatrics 2006; 37 - THP127
DOI: 10.1055/s-2006-945950

COMPARISION OF PHENOBARBITAL AND PHENYTOIN SERUM LEVELS IN CHILDREN WITH STATUS EPILEPTICUS AND REFRACTORY STATUS EPILEPTICUS

M Barzegar 1, MR Rashidi 1, AH Jafari Rouhi 1, A Joiban 1, F Jabbari 1, A Malekian 1
  • 1Division of Pediatric Neurology Tabriz Childrens, Hospital Tabriz, University of Medical Sciences, Tabriz, East Azerbaijan, Iran

Objectives: Because of high kinetic changes of antiepileptic medications in children, judgment of the efficacy of intravenous Phenytoin and Phenobarbital in treatment of refractory status epilepticus, needs measurement of serum levels of these drugs. The reason for this study is to determine and compare serum levels of Phenytoin and Phenobarbital, as two important and common first- line drugs in treatment of children with status epiepticus and refractory status epilepticus.

Methods: Serum levels of Phenytoin and Phenobarbital in 20 children (1mo –12yr) with refractory status epilepticus with 20 children with status epilepticus which presented to emergency division of pediatric hospital Tabriz faculty of medicine, was compared. The patients had been matched of age, gender, etiology, type of seizure and previous use of antiepileptic drugs.

Results: In patients with status epilepticus and refractory status epilepticus mean serum level of Phenobarbital was 28.03±12.7µg/ml, 37.22±20.78µg/ml respectively and serum level of Phenytoin was 30.38±16.80µg/ml, 31.42±14.81µg/ml respectively. There was no significant difference between Phenobarbital (P=0.1) and Phenytoin (P=0.8) serum levels in these two groups. There was no significant correlation between Phenobarbital serum level with age in the group of status epilepticus (P=0.1) and refractory status epliepticus (P=0.8). In contrast, increased Phenytoin serum level was associated with increased age in status epilapticus group (P=0.004) and refractory status epilepticus group (P=0.01). In neither of these groups blood level of these drugs was under the therapeutic level.

Conclusion: High pharmacokinetic changes in antiepileptic medications in children does'nt make any changes in serum level of intravenous Phenytoin and Phenobarbital in two groups of status epilepticus and refractory status epilepticus, and the reason for developing refractory status epilepticus may probably is the nature of disease or other unknown reasons that for recognizing them other studies are recommended.