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Kinetics of CSF Phenytoin in Children

Published online by Cambridge University Press:  18 September 2015

G. Koren ,
Z. Barzilay ,
E. Schachar ,
N. Brand ,
S. Danee ,
H. Halkin  and
S.M. MacLeod
G. Koren*
Affiliation:
Divisions of Pediatriac ICU and Clinical Pharmacology, The “Sheba” Medical Center, Tel Hashomer, Israel and The Division of Clinical Pharmacology, The Hospital for Sick Children, Toronto, Canada
Z. Barzilay
Affiliation:
Divisions of Pediatriac ICU and Clinical Pharmacology, The “Sheba” Medical Center, Tel Hashomer, Israel and The Division of Clinical Pharmacology, The Hospital for Sick Children, Toronto, Canada
E. Schachar
Affiliation:
Divisions of Pediatriac ICU and Clinical Pharmacology, The “Sheba” Medical Center, Tel Hashomer, Israel and The Division of Clinical Pharmacology, The Hospital for Sick Children, Toronto, Canada
N. Brand
Affiliation:
Divisions of Pediatriac ICU and Clinical Pharmacology, The “Sheba” Medical Center, Tel Hashomer, Israel and The Division of Clinical Pharmacology, The Hospital for Sick Children, Toronto, Canada
S. Danee
Affiliation:
Divisions of Pediatriac ICU and Clinical Pharmacology, The “Sheba” Medical Center, Tel Hashomer, Israel and The Division of Clinical Pharmacology, The Hospital for Sick Children, Toronto, Canada
H. Halkin
Affiliation:
Divisions of Pediatriac ICU and Clinical Pharmacology, The “Sheba” Medical Center, Tel Hashomer, Israel and The Division of Clinical Pharmacology, The Hospital for Sick Children, Toronto, Canada
S.M. MacLeod
Affiliation:
Divisions of Pediatriac ICU and Clinical Pharmacology, The “Sheba” Medical Center, Tel Hashomer, Israel and The Division of Clinical Pharmacology, The Hospital for Sick Children, Toronto, Canada
*
The Division of Clinical Pharmacology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario M5G 1X8.
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The efficacy of intravenous phenytoin for the treatment of status epilepticus is related to the rapid entry of phenytoin into brain parenchyma. There is no information concerning the correlation between phenytoin serum and CSF concentrations in children, and the application of CSF data to clinical use. We report 7 children (2–11 yrs) who were treated or exposed to phenytoin in doses between 10.5–230 mg/kg. Lumbar puncture was performed 9 times in 6 of the patients. In one patient, an intraventricular catheter permitted successive assessment of CSF phenytoin concentrations. The ratio of CSF/serum phenytoin concentrations was 0.16 ± 0.08, with gradual increase over the first 8 hours as the serum phenytoin concentration decreased. There was good correlation between therapeutic outcome and CSF phenytoin levels higher than 2 mcg/ml. In one patient the coma state secondary to phenytoin intoxication was associated with high CSF concentration (6 mcg/ml).

Type
Original Articles
Information
Canadian Journal of Neurological Sciences , Volume 10 , Issue 3 , August 1983 , pp. 195 - 197
Copyright
Copyright © Canadian Neurological Sciences Federation 1983

References

Buchthal, F., Svensmark, O. and Schiller, P.J. (1960). Clinical and electroencephalographic correlations with serum levels of diphenylhydantoin. Arch Neurol, 2, 624–630.CrossRefGoogle Scholar
Cranford, R.E., Leppik, I.E., Patrick, B., Andersen, C.B. and Kostick, B. (1979). Intravenous phenytoin in acute treatment of seizures. Neurology, 29, 1474–1479.CrossRefGoogle ScholarPubMed
Kutt, H., Louis, S. and McDowell, F. (1968). Intravenous diphenylhydantoin in experimental seizures. Arch Neurol, 18, 465–471.CrossRefGoogle ScholarPubMed
Kutt, H., Winters, W., Kokenge, R. and McDowell, F. (1964). Diphenylhydantoin, metabolism, blood levels and toxicity. Arch Neurol, 11, 642–48.Google ScholarPubMed
Laughman, P.M., Greenwald, A., Purton, W.W., Aranda, J.V., Watters, G. and Neims, A.H. (1977). Pharmacokinetic observations of phenytoin disposition in the newborn and young infant. Arch Dis Child., 52, 302–309.CrossRefGoogle Scholar
Laughman, P.M., Sitar, D.S., Ogilvie, R.I. and Neims, A.H. (1976). The two compartment open system kinetic mode. A review of its clinical implications and applications. J Pediatr, 88, 869–73.CrossRefGoogle Scholar
Louis, S., Kutt, H. and McDowell, F. (1968). Intravenous diphenylhydantoin in experimental seizures. Arch Neurol, 18, 472–77.CrossRefGoogle ScholarPubMed
Lund, L., Berlin, A. and Lunde, P.K.M. (1972). Plasma protein binding of diphenylhydantoin in patients with epilepsy. Clin Pharm Ther, 13, 196–200.Google ScholarPubMed
McWilliams, P.K.A. and Leeds, M.D. (1958). Intravenous phenytoin sodium in continuous convulsions in children. Lancet, 29, 1147–49.CrossRefGoogle Scholar
Painter, M.J., Pippenger, C., MacDonald, H. and Pitlick, W. (1978). Phenobarbital and diphenylhydantoin levels in neonates with seizures. J Pediatr, 92, 315–19.CrossRefGoogle ScholarPubMed
Perchalski, R.J., Scott, K. and Wilder, B.J. (1973). Rapid simultaneous GLC determination of BP, pirimidone and DPH. J Pharm Sci, 62, 1735–36.CrossRefGoogle Scholar
Wilder, B.J., Ramsay, R.E., Willmore, L.J., Feussner, G.F., Perchalski, R.J. and Shumate, J.B. (1977). Efficacy of intravenous phenytoin in the treatment of status epilepticus; kinetics of central nervous system penetration. Ann Neurol, 1, 511–18.CrossRefGoogle ScholarPubMed
Vajda, F., Williams, F.M., Davidson, S., Falconer, M.A., and Breckenridge, A. (1974). Human brain, cerebrospinal fluid and plasma concentrations of diphenylhydantoin and phenobarbital. Clin Pharm Ther, 15, 597–603.CrossRefGoogle ScholarPubMed