The efficacy of phenobarbital in controlling epilepsy in children.

Most of the new anti epileptic drugs are hard to find and expensive to be used in developing countries. We prefer phenobarbital as the first line drug because it is easily available and quite cheap. In 1986 we had 117 cases of epilepsy, excluding infantile spasms, that were treated with phenobarbital as the first line drug and had been followed up regularly from 6 months to 10 years. The cases consisted of 54 boys and 63 girls; the age of the initial visit varied between 5 months and 12 years. Overall, good results were obtained in 73 cases (62.40%), fair result in 9 cases (7.69%) and poor in 35 cases (29.91%). In relation to the type of seizures, good results occurred in 72.60% of grand-mal type, 60% of absences, 43.75% of complex partial seizures and 47.05% of partial seizures secondarily generalized. The results in myoclonic and akinetic types were poor to fair. Better results were also found in group with normal neurological status and in group without spikes in EEG examination. In only 2 cases had their phenobarbital discontinued due to its intolerable side effects. Otherwise, the only indication to change phenobarbital to other anticonvulsant was the persistence of seizures for more than 75%. We concluded that in spite of its disadvantages, phenobarbital is still good to be used as the first line drug in the treatment of epilepsy, especially in developing countries.