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A RANDOMIZED, DOUBLE-BLIND-STUDY OF PHENYTOIN FOR THE PREVENTION OF POSTTRAUMATIC SEIZURES
被引:632
作者
:
TEMKIN, NR
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV WASHINGTON,DEPT NEUROL SURG,SEATTLE,WA 98195
TEMKIN, NR
DIKMEN, SS
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV WASHINGTON,DEPT NEUROL SURG,SEATTLE,WA 98195
DIKMEN, SS
WILENSKY, AJ
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV WASHINGTON,DEPT NEUROL SURG,SEATTLE,WA 98195
WILENSKY, AJ
KEIHM, J
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV WASHINGTON,DEPT NEUROL SURG,SEATTLE,WA 98195
KEIHM, J
CHABAL, S
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV WASHINGTON,DEPT NEUROL SURG,SEATTLE,WA 98195
CHABAL, S
WINN, HR
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV WASHINGTON,DEPT NEUROL SURG,SEATTLE,WA 98195
WINN, HR
机构
:
[1]
UNIV WASHINGTON,DEPT NEUROL SURG,SEATTLE,WA 98195
[2]
UNIV WASHINGTON,DEPT BIOSTAT,SEATTLE,WA 98195
[3]
UNIV WASHINGTON,DEPT REHABIL MED,SEATTLE,WA 98195
[4]
UNIV WASHINGTON,DEPT MED,SEATTLE,WA 98195
来源
:
NEW ENGLAND JOURNAL OF MEDICINE
|
1990年
/ 323卷
/ 08期
关键词
:
D O I
:
10.1056/NEJM199008233230801
中图分类号
:
R5 [内科学];
学科分类号
:
1002 ;
100201 ;
摘要
:
Background. Antiepileptic drugs are commonly used to prevent seizures that may follow head trauma. However, previous controlled studies of this practice have been inconclusive. Methods. To study further the effectiveness of phenytoin (Dilantin) in preventing post-traumatic seizures, we randomly assigned 404 eligible patients with serious head trauma to treatment with phenytoin (n = 208) or placebo (n = 196) for one year in a double-blind fashion. An intravenous loading dose was given within 24 hours of injury. Serum levels of phenytoin were maintained in the high therapeutic range (3 to 6 μmol of free phenytoin per liter). Follow-up was continued for two years. The primary data analysis was performed according to the intention to treat. Results. Between drug loading and day 7, 3.6 percent of the patients assigned to phenytoin had seizures, as compared with 14.2 percent of patients assigned to placebo (P<0.001; risk ratio, 0.27; 95 percent confidence interval, 0.12 to 0.62). Between day 8 and the end of year 1, 21.5 percent of the phenytoin group and 15.7 percent of the placebo group had seizures; at the end of year 2, the rates were 27.5 percent and 21.1 percent, respectively (P>0.2 for each comparison; risk ratio, 1.20; 95 percent confidence interval, 0.71 to 2.02). This lack of a late effect could not be attributed to differential mortality, low phenytoin levels, or treatment of some early seizures in patients assigned to the placebo group. Conclusions. Phenytoin exerts a beneficial effect by reducing seizures only during the first week after severe head injury. (N Engl J Med 1990; 323:497–502.). © 1990, Massachusetts Medical Society. All rights reserved.
引用
收藏
页码:497 / 502
页数:6
相关论文
共 24 条
[1]
SEIZURES AFTER HEAD TRAUMA - A POPULATION STUDY
ANNEGERS, JF
论文数:
0
引用数:
0
h-index:
0
机构:
MAYO CLIN & MAYO FDN, DEPT NEUROL SURG, ROCHESTER, MN 55901 USA
ANNEGERS, JF
GRABOW, JD
论文数:
0
引用数:
0
h-index:
0
机构:
MAYO CLIN & MAYO FDN, DEPT NEUROL SURG, ROCHESTER, MN 55901 USA
GRABOW, JD
GROOVER, RV
论文数:
0
引用数:
0
h-index:
0
机构:
MAYO CLIN & MAYO FDN, DEPT NEUROL SURG, ROCHESTER, MN 55901 USA
GROOVER, RV
LAWS, ER
论文数:
0
引用数:
0
h-index:
0
机构:
MAYO CLIN & MAYO FDN, DEPT NEUROL SURG, ROCHESTER, MN 55901 USA
LAWS, ER
ELVEBACK, LR
论文数:
0
引用数:
0
h-index:
0
机构:
MAYO CLIN & MAYO FDN, DEPT NEUROL SURG, ROCHESTER, MN 55901 USA
ELVEBACK, LR
KURLAND, LT
论文数:
0
引用数:
0
h-index:
0
机构:
MAYO CLIN & MAYO FDN, DEPT NEUROL SURG, ROCHESTER, MN 55901 USA
KURLAND, LT
[J].
NEUROLOGY,
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[2]
THE INCIDENCE, CAUSES, AND SECULAR TRENDS OF HEAD TRAUMA IN OLMSTED-COUNTY, MINNESOTA, 1935-1974
ANNEGERS, JF
论文数:
0
引用数:
0
h-index:
0
ANNEGERS, JF
GRABOW, JD
论文数:
0
引用数:
0
h-index:
0
GRABOW, JD
KURLAND, LT
论文数:
0
引用数:
0
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KURLAND, LT
LAWS, ER
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0
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0
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0
LAWS, ER
[J].
NEUROLOGY,
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[3]
EVALUATION OF AN ULTRAFILTRATION FLUORESCENCE POLARIZATION IMMUNOASSAY FOR MONITORING UNBOUND PHENYTOIN
ARGYLE, JC
论文数:
0
引用数:
0
h-index:
0
ARGYLE, JC
KINNIBURGH, DW
论文数:
0
引用数:
0
h-index:
0
KINNIBURGH, DW
COSTA, R
论文数:
0
引用数:
0
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0
COSTA, R
JENNISON, T
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0
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0
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0
JENNISON, T
[J].
THERAPEUTIC DRUG MONITORING,
1984,
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[4]
Blackwood D, 1981, ADV EPILEPTOL, P521
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Copper PR, 1987, HEAD INJURY, P1
[6]
COX DR, 1972, J R STAT SOC B, V34, P187
[7]
DAVIS LJ, 1983, J NEUROSURG, V59, P729
[8]
PREDICTION OF POST-TRAUMATIC EPILEPSY - MATHEMATICAL APPROACH
FEENEY, DM
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV NEW MEXICO,DEPT SURG,ALBUQUERQUE,NM 87131
UNIV NEW MEXICO,DEPT SURG,ALBUQUERQUE,NM 87131
FEENEY, DM
WALKER, AE
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV NEW MEXICO,DEPT SURG,ALBUQUERQUE,NM 87131
UNIV NEW MEXICO,DEPT SURG,ALBUQUERQUE,NM 87131
WALKER, AE
[J].
ARCHIVES OF NEUROLOGY,
1979,
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HAINES SJ, 1983, J NEUROSURG, V59, P730
[10]
EPIDEMIOLOGY OF EPILEPSY IN ROCHESTER, MINNESOTA, 1935 THROUGH 1967
HAUSER, WA
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV MINNESOTA,ST PAUL RAMSEY HOSP & MED CTR,DEPT NEUROL,ST PAUL,MN 55101
HAUSER, WA
KURLAND, LT
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV MINNESOTA,ST PAUL RAMSEY HOSP & MED CTR,DEPT NEUROL,ST PAUL,MN 55101
KURLAND, LT
[J].
EPILEPSIA,
1975,
16
(01)
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←
1
2
3
→
共 24 条
[1]
SEIZURES AFTER HEAD TRAUMA - A POPULATION STUDY
ANNEGERS, JF
论文数:
0
引用数:
0
h-index:
0
机构:
MAYO CLIN & MAYO FDN, DEPT NEUROL SURG, ROCHESTER, MN 55901 USA
ANNEGERS, JF
GRABOW, JD
论文数:
0
引用数:
0
h-index:
0
机构:
MAYO CLIN & MAYO FDN, DEPT NEUROL SURG, ROCHESTER, MN 55901 USA
GRABOW, JD
GROOVER, RV
论文数:
0
引用数:
0
h-index:
0
机构:
MAYO CLIN & MAYO FDN, DEPT NEUROL SURG, ROCHESTER, MN 55901 USA
GROOVER, RV
LAWS, ER
论文数:
0
引用数:
0
h-index:
0
机构:
MAYO CLIN & MAYO FDN, DEPT NEUROL SURG, ROCHESTER, MN 55901 USA
LAWS, ER
ELVEBACK, LR
论文数:
0
引用数:
0
h-index:
0
机构:
MAYO CLIN & MAYO FDN, DEPT NEUROL SURG, ROCHESTER, MN 55901 USA
ELVEBACK, LR
KURLAND, LT
论文数:
0
引用数:
0
h-index:
0
机构:
MAYO CLIN & MAYO FDN, DEPT NEUROL SURG, ROCHESTER, MN 55901 USA
KURLAND, LT
[J].
NEUROLOGY,
1980,
30
(07)
: 683
-
689
[2]
THE INCIDENCE, CAUSES, AND SECULAR TRENDS OF HEAD TRAUMA IN OLMSTED-COUNTY, MINNESOTA, 1935-1974
ANNEGERS, JF
论文数:
0
引用数:
0
h-index:
0
ANNEGERS, JF
GRABOW, JD
论文数:
0
引用数:
0
h-index:
0
GRABOW, JD
KURLAND, LT
论文数:
0
引用数:
0
h-index:
0
KURLAND, LT
LAWS, ER
论文数:
0
引用数:
0
h-index:
0
LAWS, ER
[J].
NEUROLOGY,
1980,
30
(09)
: 912
-
919
[3]
EVALUATION OF AN ULTRAFILTRATION FLUORESCENCE POLARIZATION IMMUNOASSAY FOR MONITORING UNBOUND PHENYTOIN
ARGYLE, JC
论文数:
0
引用数:
0
h-index:
0
ARGYLE, JC
KINNIBURGH, DW
论文数:
0
引用数:
0
h-index:
0
KINNIBURGH, DW
COSTA, R
论文数:
0
引用数:
0
h-index:
0
COSTA, R
JENNISON, T
论文数:
0
引用数:
0
h-index:
0
JENNISON, T
[J].
THERAPEUTIC DRUG MONITORING,
1984,
6
(01)
: 117
-
120
[4]
Blackwood D, 1981, ADV EPILEPTOL, P521
[5]
Copper PR, 1987, HEAD INJURY, P1
[6]
COX DR, 1972, J R STAT SOC B, V34, P187
[7]
DAVIS LJ, 1983, J NEUROSURG, V59, P729
[8]
PREDICTION OF POST-TRAUMATIC EPILEPSY - MATHEMATICAL APPROACH
FEENEY, DM
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV NEW MEXICO,DEPT SURG,ALBUQUERQUE,NM 87131
UNIV NEW MEXICO,DEPT SURG,ALBUQUERQUE,NM 87131
FEENEY, DM
WALKER, AE
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV NEW MEXICO,DEPT SURG,ALBUQUERQUE,NM 87131
UNIV NEW MEXICO,DEPT SURG,ALBUQUERQUE,NM 87131
WALKER, AE
[J].
ARCHIVES OF NEUROLOGY,
1979,
36
(01)
: 8
-
12
[9]
HAINES SJ, 1983, J NEUROSURG, V59, P730
[10]
EPIDEMIOLOGY OF EPILEPSY IN ROCHESTER, MINNESOTA, 1935 THROUGH 1967
HAUSER, WA
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV MINNESOTA,ST PAUL RAMSEY HOSP & MED CTR,DEPT NEUROL,ST PAUL,MN 55101
HAUSER, WA
KURLAND, LT
论文数:
0
引用数:
0
h-index:
0
机构:
UNIV MINNESOTA,ST PAUL RAMSEY HOSP & MED CTR,DEPT NEUROL,ST PAUL,MN 55101
KURLAND, LT
[J].
EPILEPSIA,
1975,
16
(01)
: 1
-
66
←
1
2
3
→