Chance J F
Division of Emergency Medicine, University of Virginia Hospital, Charlottesville.
Ann Emerg Med. 1991 May;20(5):520-2. doi: 10.1016/s0196-0644(05)81606-3.
Prevention of recurrent alcohol withdrawal seizures is a common emergency department problem. A prospective, randomized, placebo-controlled, double-blind study of adequate size was designed to assess the efficacy of phenytoin in preventing recurrence of alcohol withdrawal seizures.
Fifty-five patients who had seized from alcohol withdrawal were randomly assigned to treatment with IV phenytoin or placebo. Patients with known seizure disorders and those receiving any anticonvulsant were excluded. The study was terminated after seizure recurrence or passage of a six-hour, high-risk seizure interval.
Six of 28 phenytoin-treated patients (21%) had recurrent seizures compared with five of 27 placebo-treated patients (19%). The 95% confidence interval for the difference in response probabilities was +16% to -20%. There was no statistically significant difference between the response rates for the two treatments (P greater than .05).
Phenytoin does not show significant benefit over placebo in preventing recurrence of alcohol withdrawal seizures.
预防酒精戒断后癫痫复发是急诊科常见问题。设计了一项规模足够的前瞻性、随机、安慰剂对照、双盲研究，以评估苯妥英钠预防酒精戒断后癫痫复发的疗效。
55例因酒精戒断而癫痫发作的患者被随机分配接受静脉注射苯妥英钠或安慰剂治疗。排除已知患有癫痫症的患者和正在接受任何抗惊厥药物治疗的患者。在癫痫复发或经过6小时的高风险癫痫发作间隔后，研究终止。
28例接受苯妥英钠治疗的患者中有6例（21%）出现癫痫复发，而27例接受安慰剂治疗的患者中有5例（19%）出现癫痫复发。反应概率差异的95%置信区间为+16%至-20%。两种治疗的反应率之间无统计学显著差异（P大于0.05）。
在预防酒精戒断后癫痫复发方面，苯妥英钠并未显示出比安慰剂有显著益处。
