Use of phenobarbitone for treating childhood epilepsy in resource-poor countries
Journal Article
2005
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Journal Title
South African Medical Journal
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South African Medical Journal
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University of Cape Town
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Abstract
Should the continued use of phenobarbitone for childhood epilepsy in resource-poor countries be considered a form of discrimination? Phenobarbitone was recommended by the World Health Organization (WHO) as the first-line agent for the control of seizures,1 but this has been contested on the grounds that it is biased against resource-poor countries.2 It was first used as an anticonvulsant in 1912, but now has little role to play in First-World countries where the newer generation agents are readily accessible. Phenobarbitone monotherapy has equivalent efficacy to the newer anticonvulsants (phenytoin, sodium valproate and carbamazepine) in children with partial-onset and generalised tonic-clonic seizures.3 Phenobarbitone is cheap, readily available, and easy to use and store. However, it has definite cognitive and behavioural side-effects in many children. It can exacerbate seizures in about 35% of children, and extreme caution should be taken with children who have a pre-morbid state of behavioural problems or attention deficit hyperactivity disorder (ADHD).
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Reference:
Wilmshurst, J. M., & Van Toorn, R. (2005). Use of phenobarbitone for treating childhood epilepsy in resource-poor countries: issues in medicine: SAMJ forum. South African Medical Journal, 95(6), 392.