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NEUROLOGY 1987;37:1861
© 1987 American Academy of Neurology

Phenacernide therapy of complex partial epilepsy in children

Determination of plasma drug concentrations

Steven B. Coker, MD, Earle W. Holmes, PhD and Robert T. Egel, MD

Department of Neurology (Dr. Coker) and Departments of Pathology, Biochemistry, and Biophysics (Dr. Holmes), Loyola University Medical Center, Maywood, IL, and the Department of Neurology (Dr. Egel), Christ Hospital, Oak Lawn, IL.

We used monotherapy with phenacemide to treat complex partial seizures in 13 children who were refractory to conventional antiepileptic drug therapy. Twelve patients responded with a reduction in seizure frequency, and 5 have been totally seizure free since the start of therapy. Phenacemide therapy was well tolerated with a minimum of untoward side effects and no evidence of irreversible drug toxicity. We developed a rapid and sensitive assay for the determination of plasma phenacemide concentrations by high performance liquid chromatography to monitor drug levels during therapy. Seizure control was achieved at plasma drug levels that ranged from 16 to 75 µg/ml. The median effective dose in our series was 52 µg/ml. The recurrence of seizures in three patients was, in each case, associated with trough plasma phenacemide levels below 50 µg/dl.

Address correspondence and reprint requests to Dr. Coker, Department of Neurology, Loyola University, Stritch School of Medicine, 2160 South First Avenue, Maywood, IL 60153.

Received December 1, 1986. Accepted for publication in final form February 18, 1987.






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