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Late Cognitive Effects of Early Treatment with Phenobarbital

Department of Psychiatry, University of Washington School of Medicine, Department of Pediatrics, University of Washington School of Medicine

Jacqueline R. Farwell

Department of Pediatrics, University of Washington School of Medicine

Nancy Temkin

Neurological Surgery, University of Washington School of Medicine, Seattle, WA

Ann S. Lu

Neurological Surgery, University of Washington School of Medicine, Seattle, WA

Deborah G. Hirtz

National Institute of Neurological Disorders and Stroke, Bethesda, MD

We previously reported that IQ, was significantly lowered in a group of toddler-aged children randomly assigned to receive phenobarbital or placebo for febrile seizures and there was no difference in the febrile seizure recurrence rate. We retested these children 3-5 years later, after they had entered school, to determine whether those effects persisted over the longer term and whether later school performance might be affected. On follow-up testing of 139 (of the original n=217) Western Washington children who had experienced febrile seizures, we found that the phenobarbital group scored significantly lower than the placebo group on the Wide Range Achievement Test (WRAT-R) reading achievement standard score (87.6 vs 95.6; p=0.007). There was a nonsignificant mean difference of 3.71 IQ, points on the Stanford-Binet, with the phenobarbital-treated group scoring lower (102.2 vs 105.7; p=0.09). There were five children in our sample with afebrile seizures during the 5-year period after the end of the medication trial. Two had been assigned to phenobarbital, and three had been in the placebo group. We conclude there may be a long-term adverse cognitive effect of phenobarbital on the developmental skills (language/verbal) being acquired during the period of treatment and no beneficial effect on the rate of febrile seizure recurrences or later nonfebrile seizures. Clin Pediatr. 1999;38:387-394

Clinical Pediatrics, Vol. 38, No. 7, 387-394 (1999)
DOI: 10.1177/000992289903800702


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