[Use of intravenous phenytoin in treatment of partial status epilepticus (author's transl)].

Twenty-two patients with partial status epilepticus were treated with phenytoin (DPH) intravenously (mean daily dose: 18,6 +/- 7,3 mg/kg). Benzodiazepines had been administered unsuccessfully in 18 cases before DPH. Seizures were stopped in 14 cases (less than 2 hours after the end of the initial dose in 13 cases). Failures were usually encountered in patients with severe brain damages. Adverse effects were observed in two patients: choreo-athetosic movements in one case with DPH plasma levels lower than 15 mg/l, cerebellar signs in the second patient whose DPH plasma level was 28 mg/l. As previously suggested by Cranford and al., the authors recommend a single slow intravenous infusion of 20 mg/kg (at a rate not exceeding 1 mg/kg/mn). The determination of DPH plasma concentrations demonstrated that with this procedure effective plasma levels are obtained during the 24 hours following the IV injection. In case of failure or of adverse effects determination of DPH plasma levels may be useful for adjusting the daily DPH dose.