Efficacy of five days' barbiturate: Anesthesia in the treatment of intractable epilepsies in children

Purpose: To analyze the efficacy of barbiturate anesthesia in the treatment of intractable epilepsies in childhood; Methods: Anesthesia for 4-5 days with thiopentone sodium was used to treat children with intractable epilepsy in the Department of Pediatrics, Oulu, F inland, from November 1980 through December 1995. The number of epileptic s eizures, the number and dosage of antiepileptic drugs (AEDs), and psychomot or development before and after anesthesia were compared. Results: Fifty-four children with intractable epilepsy were treated with ba rbiturate anesthesia. Twenty-four children had infantile spasms; 22, Lennox -Gastaut syndrome; seven, complex partial epilepsy; and one, myoclonic epil epsy. Twenty four (44.4%) children had complications during the anesthesia. The seizures recurred in 53 of the 54 patients in a median time of 12 days after the anesthesia. In 42 (78%) children, the seizure frequency returned to a level equal to or higher than that before the anesthesia in a median time of 211 days. The number of AEDs was significantly greater after than b efore the anesthesia (6.33 vs. 4.8; p < 0.001). Seventeen (32.5%) children mere treated surgically after the anesthesia. Conclusions: Although the seizures are eliminated or the seizure frequency decreases for a short period after the barbiturate anesthesia, the anesthes ia does not change the long-term outcome and is therefore inefficient in th e treatment of childhood intractable epilepsies.