Abstract
Triclofos sodium (Tricloryl) is used widely as the most available hypnotics in pediatricn practice, but there have been few reports about its use as an anticonvulsant. We report a girl with refractory epilepsy, including life-threatening status epilepticus, whose seizures responded to triclofos sodium given orally.
She had been in a normal perinatal period until fits commenced at five days of age. There were frequent tonic spasms in series during awake and sleep period. Electroencephalogram showed suppression-burst when awake or asleep, in addition to desynchronization during seizures. These characteristics were corresponded to the early infantile epileptic encephalopathy with suppression-burst of Ohtahara. Her seizures were resistent to various anticonvulsants in combination, and thereafter showed the transition to West syndrome at three months. In 1984, aged fourteen months, she was admitted to our hospital having daily one hundred or more generalized convulsions of up to three minutes duration. These continued despite intravenous infusion of diazepam, phenytoin, gammaglobulin and lidocaine and were not controlled even by intravenous infusion of thiamyral sodium and pancronium bromdie under artificial ventilation. At this stage, triclofos sodium was introduced orally in a dosage of 100mg/kg in every 8 hours, in part for its sedative action. Within three hours of starting the dosage the fit frequency decreased and stopped completely. After three days the dosage of triclofos sodium was gradually reduced and finally withdrawn, but seizures did not recur.
This case report suggests that triclofos sodium may give benefit for children whose seizures are refractory to conventional treatment, especially for those in status epilepticus.
