Sulzbacher S, Farwell J R, Temkin N, Lu A S, Hirtz D G
Department of Psychiatry, University of Washington School of Medicine, Seattle, USA.
Clin Pediatr (Phila). 1999 Jul;38(7):387-94. doi: 10.1177/000992289903800702.
We previously reported that IQ was significantly lowered in a group of toddler-aged children randomly assigned to receive phenobarbital or placebo for febrile seizures and there was no difference in the febrile seizure recurrence rate. We retested these children 3-5 years later, after they had entered school, to determine whether those effects persisted over the longer term and whether later school performance might be affected. On follow-up testing of 139 (of the original n = 217) Western Washington children who had experienced febrile seizures, we found that the phenobarbital group scored significantly lower than the placebo group on the Wide Range Achievement Test (WRAT-R) reading achievement standard score (87.6 vs 95.6; p = 0.007). There was a nonsignificant mean difference of 3.71 IQ points on the Stanford-Binet, with the phenobarbital-treated group scoring lower (102.2 vs 105.7; p = 0.09). There were five children in our sample with afebrile seizures during the 5-year period after the end of the medication trial. Two had been assigned to phenobarbital, and three had been in the placebo group. We conclude there may be a long-term adverse cognitive effect of phenobarbital on the developmental skills (language/verbal) being acquired during the period of treatment and no beneficial effect on the rate of febrile seizure recurrences or later nonfebrile seizures.
我们之前报道过，在一组因高热惊厥而被随机分配接受苯巴比妥或安慰剂治疗的幼儿中，智商显著降低，且高热惊厥复发率并无差异。在这些孩子入学3至5年后，我们对他们进行了重新测试，以确定这些影响是否会长期持续，以及后期的学业表现是否会受到影响。在对139名（最初的n = 217名）曾经历过高热惊厥的华盛顿西部儿童进行随访测试时，我们发现，在广泛成就测验（WRAT-R）阅读成就标准分数方面，苯巴比妥组的得分显著低于安慰剂组（87.6对95.6；p = 0.007）。在斯坦福-比奈智力量表上，两组的平均智商差异为3.71分，不显著，苯巴比妥治疗组得分较低（102.2对105.7；p = 0.09）。在药物试验结束后的5年期间，我们的样本中有5名儿童出现了无热惊厥。其中2名被分配到苯巴比妥组，3名在安慰剂组。我们得出结论，苯巴比妥可能对治疗期间正在获得的发育技能（语言/言语）有长期的不良认知影响，对高热惊厥复发率或后期的无热惊厥没有有益影响。
