{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,30]],"date-time":"2026-04-30T05:42:42Z","timestamp":1777527762466,"version":"3.51.4"},"reference-count":14,"publisher":"SAGE Publications","issue":"9","license":[{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2025,3,24]],"date-time":"2025-03-24T00:00:00Z","timestamp":1742774400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Clin Pediatr (Phila)"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:p>\n                    In this study, we applied high-dose oral phenobarbital (PB) to children with recurrent and treatment-refractory seizures or recurrent status epilepticus and evaluated the effectiveness and safety of this treatment. We retrospectively reviewed patients\u2019 medical records who received oral high-dose PB treatment between January 2019 and July 2024. In this study, recurrent and treatment-refractory seizures was defined as the persistence of daily epileptic seizures or recurrent attacks of status epilepticus despite treatment with oral antiepileptic drugs or continuous intravenous midazolam therapy. High-dose oral PB therapy was performed on 11 patients (7 females and 4 males). The median age at the onset of epilepsy was 2 months (range: 0.06-132 months). The underlying disorders or comorbidity were genetic disorders (1q14 del, compound heterozygous for the\n                    <jats:italic>PNKP gene<\/jats:italic>\n                    , Wolf-Hirschhorn syndrome, ring chromosome 14 syndrome) in 4 patients, cerebral palsy in 2 patients, metabolic disorders (Zellweger syndrome, pyridoxine-dependent epilepsy) in 2 patients, traumatic brain injury and hypoxia, hemimegalencephaly, and ataxia and intellectual disability in 1 patient. The median age at initiation of high-dose PB therapy was 11 months (range: 2-203 months). The maximal dose of PB ranged from 6 to 14.7 mg\/kg\/d (median: 10 mg\/kg\/day). The maximal serum PB levels ranged from 33 to 56 \u00b5g\/mL (median: 44 \u00b5g\/mL). We evaluated the effectiveness of this treatment as follows: \u201ceffective\u201d represented more than 50% seizure reduction, \u201cineffective\u201d represented less than 50% seizure reduction, and \u201cexacerbation\u201d represented an increase in seizure frequency. In 7 of the 11 patients (63.6%), oral high-dose PB therapy was effective and was transiently effective in the other 4 patients. Adverse effects were noted in 6 patients (54.5%) during high-dose oral PB therapy: drowsiness in 5 patients and mild elevations in transaminases in 2 patients.\n                  <\/jats:p>","DOI":"10.1177\/00099228251328136","type":"journal-article","created":{"date-parts":[[2025,3,25]],"date-time":"2025-03-25T10:48:29Z","timestamp":1742899709000},"page":"1259-1263","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Effectiveness and Safety of High-Dose Oral Phenobarbital in Children With Recurrent and Treatment-Refractory Seizures"],"prefix":"10.1177","volume":"64","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2588-8195","authenticated-orcid":false,"given":"Muhittin","family":"Bodur","sequence":"first","affiliation":[{"name":"Bursa Uludag University, Pediatric Neurology, Bursa, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3129-334X","authenticated-orcid":false,"given":"Rabia","family":"Tutuncu Toker","sequence":"additional","affiliation":[{"name":"Bursa Uludag University, Pediatric Neurology, Bursa, Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"179","published-online":{"date-parts":[[2025,3,24]]},"reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.2165\/00003088-199529040-00005"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.yebeh.2023.109104"},{"key":"e_1_3_2_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.seizure.2008.07.006"},{"key":"e_1_3_2_5_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.38.7.1035"},{"key":"e_1_3_2_6_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.pediatrneurol.2005.06.014"},{"key":"e_1_3_2_7_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.braindev.2017.11.009"},{"key":"e_1_3_2_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0887-8994(01)00365-4"},{"key":"e_1_3_2_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.braindev.2010.07.009"},{"key":"e_1_3_2_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.braindev.2015.10.011"},{"key":"e_1_3_2_11_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.braindev.2019.04.007"},{"key":"e_1_3_2_12_2","doi-asserted-by":"publisher","DOI":"10.1111\/j.1440-1754.2009.01611.x"},{"issue":"1","key":"e_1_3_2_13_2","first-page":"23","article-title":"Non-intravenous high-dose phenobarbital therapy for status epilepticus refractory to continuous infusion of midazolam or pentobarbital: report of three cases","volume":"34","author":"Sudoh A","year":"2002","unstructured":"Sudoh A, Sugai K, Miyamoto T, et al. Non-intravenous high-dose phenobarbital therapy for status epilepticus refractory to continuous infusion of midazolam or pentobarbital: report of three cases. No To Hattatsu. 2002;34(1):23-29.","journal-title":"No To Hattatsu"},{"key":"e_1_3_2_14_2","doi-asserted-by":"publisher","DOI":"10.1111\/epi.12027"},{"issue":"2","key":"e_1_3_2_15_2","first-page":"117","article-title":"Antiepileptic drugs in children","volume":"22","author":"Karacabey BN","year":"2022","unstructured":"Karacabey BN, Pembegul Yildiz E, Caliskan M. Antiepileptic drugs in children. J Child. 2022;22(2):117-123.","journal-title":"J Child"}],"container-title":["Clinical Pediatrics"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00099228251328136","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/00099228251328136","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/00099228251328136","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,4,28]],"date-time":"2026-04-28T16:34:10Z","timestamp":1777394050000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/00099228251328136"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,3,24]]},"references-count":14,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2025,10]]}},"alternative-id":["10.1177\/00099228251328136"],"URL":"https:\/\/doi.org\/10.1177\/00099228251328136","relation":{},"ISSN":["0009-9228","1938-2707"],"issn-type":[{"value":"0009-9228","type":"print"},{"value":"1938-2707","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,3,24]]}}}