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Ann Emerg Med. 1994 Mar;23(3):513-8.

The lack of efficacy of phenytoin in the prevention of recurrent alcohol-related seizures.

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1
Emergency Department, Boston City Hospital, Massachusetts.

Abstract

STUDY OBJECTIVE:

To determine the effectiveness of IV phenytoin in the prevention of recurrent alcohol-related seizures during a six-hour observation period.

DESIGN:

Prospective, randomized, double-blind trial comparing IV phenytoin with normal saline placebo, conducted from January 1990 through December 1991.

SETTING:

Emergency department of an inner-city, university-affiliated, teaching hospital.

PARTICIPANTS:

One hundred forty-seven consecutive adults more than 25 years of age who presented with a witnessed generalized seizure in the setting of chronic alcohol abuse.

INTERVENTIONS:

Eligible subjects received 15 mg/kg of phenytoin or normal saline at an equivalent volume over 20 minutes by IV pump. Patients were observed for six hours in the ED after drug administration. Those experiencing a second seizure were admitted to the hospital.

RESULTS:

One hundred patients completed the study. Recurrent alcohol-related seizures occurred in ten of 49 patients (20.4%) in the phenytoin group and in 12 of 51 patients (23.5%) in the placebo group. chi 2 analysis revealed no statistically significant difference between the two groups (chi 2 = 0.142; P = .706). The 95% confidence interval for the difference was -0.13 to + 0.19. The relative risk of recurrence between groups was 0.868 with a 95% confidence interval of 0.412 to 1.826.

CONCLUSION:

No significant benefit of phenytoin administration in the prevention of recurrent alcohol-related seizures during a six-hour observation period was demonstrated.

PMID:
8135426
DOI:
10.1016/s0196-0644(94)70070-2
[Indexed for MEDLINE]

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