An Effective dose Schedule for Phenytoin Treatment of Status Epilepticus in Infancy and Childhood

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Abstract
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 μg/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. 1 Supported by Deutsche Forschungsgemeinschaft, AL 148