Document Detail

Long-term outcome of phenobarbital treatment for epilepsy in rural China: A prospective cohort study.
MedLine Citation:
PMID:  23163288     Owner:  NLM     Status:  Publisher    
Purpose:  To evaluate the long-term outcome of phenobarbital treatment for convulsive epilepsy in rural China, and to explore factors associated with overall seizure outcomes. Methods:  We carried out follow-up assessments of people who took part in an epilepsy community management program conducted in rural counties of six provinces in China. People with convulsive epilepsy who were previously untreated (or on irregular treatment) were commenced on regular treatment with phenobarbital. Information was collected using a standardized questionnaire by face-to-face interviews of the individuals (and their families where necessary). Information collected included treatment status, medication change, seizure frequency, and mortality. Key Findings:  Among the 2,455 people who participated in the original program, outcomes were successfully ascertained during the follow-up assessment in 1986. Among them, 206 had died. Information on treatment response was obtained in 1,780 (56% male; mean age 33.9 years, range 3-84; mean duration of follow-up 6.4 years). Among them, 939 (53%) were still taking phenobarbital. The most common reasons for stopping phenobarbital were seizure freedom or substantial seizure reduction, socioeconomic reasons, and personal preference. Four hundred fifty-three individuals (25%) became seizure-free for at least 1 year while taking phenobarbital, 88% of whom did so at daily doses of 120 mg or below. Four hundred six (23%) reported adverse events, which led to withdrawal of phenobarbital in <1%. The most common adverse effects were malaise/somnolence (7.4%), dizziness (3%), and lethargy (2.6%). At the follow-up assessment, 688 (39%) individuals had been seizure free for at least the previous year. People with persistent seizures had significantly longer duration of epilepsy and higher number of seizures in the 12 months before treatment. People who were taking AED treatment irregularly at recruitment were less likely to become seizure-free. Significance:  We observed long-term benefits of regular treatment with phenobarbital for convulsive epilepsy in rural China. One hundred years after the discovery of its antiepileptic effect, phenobarbital is still playing an important role in the management of epilepsy.
Patrick Kwan; Wenzhi Wang; Jianzhong Wu; Shichuo Li; Hongchao Yang; Ding Ding; Zhen Hong; Xiuying Dai; Bing Yang; Taiping Wang; Chenglin Yuan; Guangyu Ma; Hanneke M de Boer; Josemir W Sander
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Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2012-11-13
Journal Detail:
Title:  Epilepsia     Volume:  -     ISSN:  1528-1167     ISO Abbreviation:  Epilepsia     Publication Date:  2012 Nov 
Date Detail:
Created Date:  2012-11-20     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  2983306R     Medline TA:  Epilepsia     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Copyright Information:
© 2012 International League Against Epilepsy.
Departments of Medicine and Neurology, The University of Melbourne, Royal Melbourne Hospital, Melbourne, Victoria, Australia Department of Medicine and Therapeutics, The Chinese University of Hong Kong, Prince of Wales Hospital, Hong Kong, China Beijing Neurosurgical Institute, Capital Medical University, Beijing, China China Association Against Epilepsy, Beijing, China Institute of Neurology, Fudan University, Shanghai, China Ningxia Medical College, Ningxia Hui Autonomous Region, China Jiaozuo People's Hospital, Henan Province, China Zezhou County Hospital, Shanxi Province, China Department of Neurology, Clinical Medical College of Yangzhou University, Yangzhou, Jiangsu Province, China Universal Love Hospital, Mudanjiang, Heilongjiang Province, China SEIN - Epilepsy Institute in the Netherlands Foundation & WHO Collaborating Centre for Research, Training and Treatment of Epilepsy, Heemstede, The Netherlands Department of Clinical & Experimental Epilepsy, UCL Institute of Neurology, London, United Kingdom Epilepsy Society, Chalfont St Peter, United Kingdom.
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