Nakazawa Mika, Toda Soichiro, Abe Shinpei, Ikeno Mitsuru, Igarashi Ayuko, Nakahara Eri, Yamashita Shintaro, Niijima Shinichi, Shimizu Toshiaki, Okumura Akihisa
Department of Pediatrics, Juntendo University Faculty of Medicine, Japan.
Department of Pediatrics, Kameda Medical Center, Japan.
Brain Dev. 2015 Oct;37(9):864-7. doi: 10.1016/j.braindev.2015.02.001. Epub 2015 Feb 20.
To clarify the efficacy and safety of fosphenytoin for seizures in children with benign convulsions and mild gastroenteritis.
Using the mailing list of the Annual Zao Conference on Pediatric Neurology, we recruited patients who met the following criteria: (1) clinical diagnosis of benign convulsions with mild gastroenteritis and (2) treatment with intravenous fosphenytoin. Benign convulsions with mild gastroenteritis were defined as a condition of (a) seizures associated with gastroenteritis without electrolyte imbalance, hypoglycemia, or dehydration in patients (b) between 6 months and 3 years of age with (c) no preexisting neurological disorders, (d) no impaired consciousness, and (e) a body temperature less than 38.0 °C before and after the seizures. The efficacy of fosphenytoin was categorized as effective when cessation of seizures was achieved.
Data from 16 child patients were obtained (median age, 20 months). Seizures were completely controlled after the initial dose of fosphenytoin in 14 of 16 patients. The median loading dose of fosphenytoin was 22.5 mg/kg. In 10 patients, fosphenytoin was administered after other antiepileptic drugs such as diazepam and midazolam were used. Adverse effects of fosphenytoin, excessive sedation, or intravenous fluid incompatibility were not observed in any patients.
Fosphenytoin is effective and well tolerated among children with benign convulsions with mild gastroenteritis.
阐明磷苯妥英对患有良性惊厥和轻度肠胃炎儿童癫痫发作的疗效和安全性。
利用小儿神经学年度枣会议的邮件列表，我们招募了符合以下标准的患者：（1）临床诊断为良性惊厥合并轻度肠胃炎；（2）接受静脉注射磷苯妥英治疗。良性惊厥合并轻度肠胃炎定义为：（a）与肠胃炎相关的癫痫发作，患者无电解质失衡、低血糖或脱水；（b）年龄在6个月至3岁之间；（c）既往无神经疾病；（d）意识无受损；（e）癫痫发作前后体温低于38.0°C。当癫痫发作停止时，磷苯妥英的疗效被分类为有效。
获得了16例儿童患者的数据（中位年龄，20个月）。16例患者中有14例在首次使用磷苯妥英后癫痫发作得到完全控制。磷苯妥英的中位负荷剂量为22.5mg/kg。在10例患者中，在使用地西泮和咪达唑仑等其他抗癫痫药物后使用了磷苯妥英。未观察到任何患者出现磷苯妥英的不良反应、过度镇静或静脉输液不相容性。
磷苯妥英对患有良性惊厥和轻度肠胃炎的儿童有效且耐受性良好。
