An effective dose schedule for phenytoin treatment of status epilepticus in infancy and childhood.

Fifteen infants and children were treated with phenytoin for status epilepticus. They received doses 31.5 mg/kg (18--46) in the first 24 hours, 18.5 mg/kg (10--28) on the second day and 11 mg/kg (7.7--15.4) on the third day controlled by frequent serum level determinations. After reaching the upper therapeutic range (8--25 microgram/ml) within 24 hours these serum concentrations were maintained over the next days. Twelve of fifteen--including five newborns and infants below four months of age--were thus successfully treated; the remaining three in whom phenytoin had no effect, no other anticonvulsant drug or a combination of several other drugs were successful. A dose schedule based upon serial serum concentration measurements is given. It enables an efficient phenytoin treatment of status epilepticus or equivalent convulsive states in infancy and childhood.