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- MEDICINE, Page 74Worse Than The Disease
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- In youngsters, phenobarbital may do more harm than good
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- The child's body turns rigid, the eyes roll back, and the
- limbs begin to jerk. These are the frightening signs of a
- febrile seizure. Triggered by a high fever, often during an
- infectious illness such as tonsillitis or flu, this type of
- convulsion is caused by violent nerve storms in the brain.
- About 130,000 of the 4 million children born each year in the
- U.S. will have at least one febrile seizure by the time they
- turn seven.
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- To prevent additional seizures and satisfy worried parents,
- physicians often prescribe phenobarbital. But according to a
- report in last week's New England Journal of Medicine, the drug
- may do more harm than good. In a study of 217 children from
- eight months to three years of age who had had at least one
- seizure, researchers at the University of Washington and the
- National Institutes of Health found that children who took
- phenobarbital daily for up to two years had significantly lower
- IQ scores than those who were given a placebo. Some difference
- was still apparent several months after they stopped taking the
- drug, but it is not known whether the impact will be permanent.
- To make matters worse, phenobarbital was not effective in
- suppressing seizures.
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- Since most febrile seizures are scary but harmless,
- researchers say, there is little reason ever to use
- phenobarbital as a treatment. About one-third of all the
- children who have these convulsions are likely to have
- subsequent ones, but only 4% eventually develop epilepsy.
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- Phenobarbital was once widely prescribed as a sleeping pill,
- and is still used by epileptics of all ages, but its impact on
- the intelligence of adults is not known. Despite the new
- evidence against phenobarbital, people taking the drug should
- not stop without consulting a doctor. As with any
- anticonvulsant, going cold turkey may trigger severe seizures.
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