PHENOBARBITAL FOR FEBRILE SEIZURES - EFFECTS ON INTELLIGENCE AND ON SEIZURE RECURRENCE
PHENOBARBITAL FOR FEBRILE SEIZURES - EFFECTS ON INTELLIGENCE AND ON SEIZURE RECURRENCE
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DOI：
10.1056/nejm199002083220604
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发表时间：
1990-02-08
影响因子：
158.5
通讯作者：
NELSON, KB
中科院分区：
文献类型：
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作者：
FARWELL, JR;LEE, YJ;NELSON, KB
苯巴比妥被广泛用于治疗儿童热性惊厥，尽管存在可能的行为和认知副作用的担忧。在217名年龄在8 ~ 36个月之间的儿童中，他们至少有过一次热性癫痫发作，并且有进一步癫痫发作的高风险，我们比较了随机分配到每日剂量苯巴比妥（每天每公斤体重4 ~ 5 mg）组和随机分配到安慰剂组的智商（IQ）。两年后，苯巴比妥组的平均智商比安慰剂组低8.4分（95%置信区间为-13.3 ~-3.5，P = 0.0057）。6个月后，在药物逐渐减少并停止后，苯巴比妥组的平均智商低5.2分（95%置信区间，-10.5至0.04，P = 0.052）。两个治疗组之间保持无后续癫痫发作的儿童比例无显著差异。我们的结论是，苯巴比妥抑郁症的认知表现在儿童治疗热性惊厥，这可能会超过几个月的药物管理的缺点，是不能抵消的好处，癫痫发作的预防。
Phenobarbital is widely used in the treatment of children with febrile seizures, although there is concern about possible behavioral and cognitive side effects. In 217 children between 8 and 36 months of age who had had at least one febrile seizure and were at heightened risk of further seizures, we compared the intelligence quotients (IQs) of a group randomly assigned to daily doses of phenobarbital (4 to 5 mg per kilogram of body weight per day) with the IQs of a group randomly assigned to placebo. After two years, the mean IQ was 8.4 points lower in the group assigned to phenobarbital than in the placebo group (95 percent confidence interval, -13.3 to -3.5, P = 0.0057). Six months later, after the medication had been tapered and discontinued, the mean IQ was 5.2 points lower in the group assigned to phenobarbital (95 percent confidence interval, -10.5 to 0.04, P = 0.052). The proportion of children remaining free of subsequent seizures did not differ significantly between the treatment groups. We conclude that phenobarbital depresses cognitive performance in children treated for febrile seizures and that this disadvantage, which may outlast the administration of the drug by several months, is not offset by the benefit of seizure prevention.