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Adjunctive enteral phenobarbital for adult status epilepticus: a brief report

Somsak Tiamkao1, Kornkanok Suttapan2, Sineenard Pranbul3

  • 1Department of Medicine, Faculty of Medicine, Khon Kaen University, Khon Kaen, Thailand ; Integrated Epilepsy Research Group, Khon Kaen University, Khon Kaen, Thailand.

Neuropsychiatric Disease and Treatment
|January 1, 2014
PubMed

Insights

Enteral phenobarbital (PB) offers a viable treatment for refractory status epilepticus (SE) when IV access is limited. This study found enteral PB effective in adult SE patients, with no adverse effects observed.

Area of Science:

  • Neurology
  • Clinical Pharmacology

Background:

  • Status epilepticus (SE) is a critical neurological emergency.
  • Intravenous phenobarbital (PB) is the recommended treatment for refractory SE.
  • Intravenous PB is not available in Thailand, necessitating alternative administration routes.

Purpose of the Study:

  • To evaluate the efficacy of enteral phenobarbital (PB) as an adjunctive therapy for refractory status epilepticus (SE) in adult patients.
  • To report clinical features and outcomes of adult SE patients treated with enteral PB in Thailand.

Main Methods:

  • A case series of adult SE patients treated with enteral PB at Khon Kaen University Hospital.
  • Patients received an initial enteral PB dose of 900 mg, with repeated doses as needed, followed by a maintenance dosage of 180 mg/day.

Main Results:

  • Six adult patients with SE (five convulsive, one nonconvulsive) were included.
  • Three patients achieved complete seizure control, and three achieved partial control.
  • Three patients were seizure-free after the initial loading dose; no adverse effects were reported.

Conclusions:

  • Enteral phenobarbital (PB) demonstrates potential efficacy as an add-on therapy for refractory status epilepticus (SE) in adult patients.
  • Enteral administration provides a feasible alternative when intravenous PB is unavailable.
Abstract

Keywords:
Thailandclinical outcomesefficacyrefractory status epilepticus

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