EMERGENCY DEPARTMENT TREATMENT OF ALCOHOL-WITHDRAWAL SEIZURES WITH PHENYTOIN

被引：38

作者：

CHANCE, JF

机构：

[1] Division of Emergency Medicine, University of Virginia Hospital, Charlottesville

来源：

ANNALS OF EMERGENCY MEDICINE | 1991年 / 20卷 / 05期

关键词：

alcohol withdrawal delirium; phenytoin; seizure;

D O I：

10.1016/S0196-0644(05)81606-3

中图分类号：

R4 [临床医学];

学科分类号：

1002 ; 100602 ;

摘要：

Study objective: Prevention of recurrent alcohol withdrawal seizures is a common emergency department problem. A prospective, randomized, placebo-controlled, double-blind study of adequate size was designed to assess the efficacy of phenytoin in preventing recurrence of alcohol withdrawal seizures. Methods: Fifty-five patients who had seized from alcohol withdrawal were randomly assigned to treatment with IV phenytoin or placebo. Patients with known seizure disorders and those receiving any anticonvulsant were excluded. The study was terminated after seizure recurrence or passage of a six-hour, high-risk seizure interval. Results: Six of 28 phenytoin-treated patients (21%) had recurrent seizures compared with five of 27 placebo-treated patients (19%). The 95% confidence interval for the difference in response probabilities was + 16% to -20%. There was no statistically significant difference between the response rates for the two treatments (P > .05). Conclusion: Phenytoin does not show significant benefit over placebo in preventing recurrence of alcohol withdrawal seizures.

引用

页码：520 / 522

页数：3

共 12 条

[1]

Earnest, Yarnell, Seizure admissions to a city hospital: The role of alcohol, Epilepsia, 17, pp. 387-393, (1976)

[2]

Victor, Brausch, The role of abstinence in the genesis of alcoholic epilepsy, Epilepsia, 8, pp. 1-20, (1967)

[3]

Carducci, Hedges, Beal, Et al., Emergency phenytoin loading by constant intravenous infusion, Ann Emerg Med, 13, pp. 1027-1031, (1984)

[4]

Sampliner, Iber, Diphenylhydantoin control of alcohol withdrawal seizures: Results of a controlled study, JAMA, 230, pp. 1430-1432, (1974)

[5]

Earnest, Marx, Drury, Complications of intravenous phenytoin for acute treatment of seizures, JAMA, 249, pp. 762-765, (1983)

[6]

Simon, Confidence intervals for reporting the results of clinical trials, Ann Intern Med, 105, pp. 429-435, (1986)

[7]

Morris, Victor, Alcohol withdrawal seizures, Emerg Med Clin North Am, 5, pp. 827-839, (1987)

[8]

Essig, Carter, Failure of diphenylhydantoin in preventing barbiturate withdrawal convulsions in the dog, Neurology, 12, pp. 481-484, (1962)

[9]

Chu, Prevention of alcohol withdrawal seizures with phenytoin in rats, Epilepsia, 22, pp. 179-184, (1981)

[10]

Alldredge, Lowenstein, Simon, Placebo-controlled trial of intravenous diphenylhydantoin for short-term treatment of alcohol withdrawal seizures, Am J Med, 87, pp. 645-648, (1989)

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