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Phenobarbital in the prophylaxis of late posttraumatic seizures

L Murri1, A Arrigo, U Bonuccelli

  • 1Clinica Neurologica, Università di Pisa.

Italian Journal of Neurological Sciences
|December 1, 1992
PubMed

Insights

Phenobarbital (PB) effectively reduced the incidence of posttraumatic epilepsy (PTE) in severe head injury patients. This study shows PB

Area of Science:

  • Neurology
  • Clinical Pharmacology
  • Traumatology

Background:

  • Posttraumatic epilepsy (PTE) is a significant complication following severe head injuries.
  • Effective prophylactic strategies for PTE are crucial for improving patient outcomes.

Purpose of the Study:

  • To evaluate the efficacy of phenobarbital (PB) in reducing the incidence of posttraumatic epilepsy (PTE) in patients with severe head injuries.
  • To determine optimal dosing and therapeutic plasma concentrations of PB for PTE prophylaxis.

Main Methods:

  • A prospective study involving 390 patients with severe head injuries.
  • Intramuscular and oral administration of phenobarbital (PB) for 12 months.
  • Monitoring of serial plasma PB concentrations to maintain levels between 5 and 30 micrograms/ml.

Main Results:

  • Out of 293 patients who completed the study, only 6 (2.04%) experienced seizures.
  • Seizures occurred at plasma PB concentrations ranging from 20 to 28 micrograms/ml.
  • PB administration demonstrated a prophylactic effect on PTE, even at relatively low doses.

Conclusions:

  • Phenobarbital (PB) administered within the first 12 months post-trauma can significantly reduce the incidence of posttraumatic epilepsy (PTE).
  • Therapeutic plasma concentrations of PB between 20-28 micrograms/ml appear effective in preventing seizures in this patient population.

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