Related Experiment Video

Updated: Jun 21, 2026

Cerebral Ischemic Coma Model Induced by Modified Four-Vessel Occlusion
03:37

Cerebral Ischemic Coma Model Induced by Modified Four-Vessel Occlusion

Published on: July 5, 2024

Reversible coma associated with prolonged high-dose phenobarbital therapy in bilateral Sturge-Weber syndrome

Hiroyuki Wakamoto1, Yasuko Nakamura, Tomohiro Ebihara

  • 1Department of Pediatrics, Ehime Prefecture Central Hospital, Matsuyama City, Ehime Prefecture, Japan. hirwaka@hotmail.com

Journal of Child Neurology
|August 13, 2009
PubMed

Insights

High-dose phenobarbital effectively treats refractory status epilepticus. However, prolonged use in infants with severe cerebrovascular disease may cause neurological complications, necessitating careful monitoring.

Area of Science:

  • Neurology
  • Pediatrics
  • Pharmacology

Background:

  • High-dose phenobarbital is a recognized treatment for refractory status epilepticus in children.
  • Limited data exists on the safety of long-term phenobarbital administration.

Observation:

  • An infant with intractable epilepsy and bilateral Sturge-Weber syndrome developed coma after 1 2/3 months of high-dose phenobarbital.
  • Recovery of consciousness correlated with decreased serum phenobarbital levels (<40 microg/mL).
  • Electroencephalogram and brainstem auditory evoked potentials documented the neurological changes.

Findings:

  • Prolonged high-dose phenobarbital therapy can lead to cerebral and brainstem dysfunction.
  • Patients with severe cerebrovascular disease may be at higher risk for these complications.

Implications:

  • This case highlights the potential neurotoxicity of long-term high-dose phenobarbital in vulnerable pediatric populations.
  • Careful monitoring of neurological function is crucial during extended phenobarbital treatment, especially in patients with underlying cerebrovascular conditions.

More Related Videos

Induction of an Isoelectric Brain State to Investigate the Impact of Endogenous Synaptic Activity on Neuronal Excitability In Vivo10:19

Induction of an Isoelectric Brain State to Investigate the Impact of Endogenous Synaptic Activity on Neuronal Excitability In Vivo

Published on: March 31, 2016

Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy09:57

Electromagnetic Source Imaging in Presurgical Evaluation of Children with Drug-Resistant Epilepsy

Published on: September 20, 2024

Related Concept Videos

CNS Depressants: Barbiturates and Benzodiazepines01:14

CNS Depressants: Barbiturates and Benzodiazepines

CNS depressants include drugs from the category of barbiturates and benzodiazepines. They are valuable medications for managing anxiety disorders and insomnia. Barbiturates, once used to induce and maintain sleep, have been replaced mainly by benzodiazepines due to barbiturate's toxicity, tolerance, and overdose risks. They interact with GABAA receptors, leading to sedation at low doses and potentially coma and death at higher doses. Phenobarbital, a long-acting barbiturate, possesses...
Sedatives and Hypnotics Drugs: Barbiturates01:20

Sedatives and Hypnotics Drugs: Barbiturates

Sedatives and hypnotics encompass a drug class that acts on the central nervous system (CNS) to alleviate anxiety, promote relaxation and induce sleep.These drugs function by amplifying the actions of the neurotransmitter γ-aminobutyric acid (GABA), resulting in reduced neuronal activity. Barbiturates, a subset of sedatives and hypnotics first synthesized in the late 1800s, are categorized into ultra-short, short, intermediate, and long-acting groups based on their duration of effect. A key...
Stages of General Anesthesia01:22

Stages of General Anesthesia

Various sedation levels offer significant advantages in facilitating procedural interventions for patients undergoing medical or invasive surgical procedures. These levels span from anxiolysis to general anesthesia, providing a spectrum of sedative effects to cater to specific patient needs. Anxiolysis reduces anxiety and is achieved through minimal sedation, enabling patients to remain awake and responsive while feeling more at ease during the procedure. This level can benefit minor...
Antiepileptic Drugs: GABAergic Pathway Potentiators01:18

Antiepileptic Drugs: GABAergic Pathway Potentiators

γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for their...
Seizures l: Introduction01:20

Seizures l: Introduction

Understanding seizures and epilepsy relies on key definitions that help in recognizing, classifying, and managing these disorders. These definitions provide a framework for recognizing, classifying, and managing seizure disorders.DefinitionsA seizure is a sudden, abnormal burst of electrical activity in the brain that can cause changes in awareness, movement, sensation, or behavior, depending on the area involved. Epilepsy is a chronic condition characterized by recurrent, unprovoked seizures,...
Hepatic Encephalopathy01:29

Hepatic Encephalopathy

DefinitionHepatic encephalopathy is a reversible neurologic syndrome that results from advanced liver dysfunction or portosystemic shunting. It leads to disturbances in cognition, behavior, and motor function due to the brain’s exposure to gut-derived toxins that the liver fails to detoxify.EtiologyThis condition develops either in the setting of acute fulminant hepatitis or progressively during chronic liver disease, such as cirrhosis and portal hypertension. Portosystemic shunting—including...