Abstract
This study retrospectively evaluated the efficacy and pharmacokinetics of fosphenytoin (fos-PHT) in treating status epilepticus (SE) and cluster seizures in a group of 24 children (n=10 aged<2 years, n=14 aged≥2 years). Common etiologies were acute symptomatic SE in the<2 years old group (42.3%) and remote symptomatic SE in the≥2 years old group (80.0%). Fos-PHT was effective in treating approximately 70% of subjects in both groups. Transient hypotension was apparent as a mild adverse side effect in one child in the≥2 years old group. Serum PHT levels gradually decreased after initial Fos-PHT administration (22.5mg/kg) with no significant difference between the two groups, and reached suboptimal levels within 10-15 h. Longer maintenance fos-PHT therapy (7.5mg/kg/day) also could not maintain optimal serum PHT levels. We conclude that fos-PHT is effective and safe for treating status epilepticus and cluster seizures in children including those aged<2 years. To maintain optimal serum PHT levels, high doses of fos-PHT, similar to those administered outside of Japan, might be required.
