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NEUROLOGY 1986;36:108
© 1986 American Academy of Neurology

Intravenous paraldehyde for seizure control in newborn infants

Gideon Koren, MD, Warwick Butt, MD, Percy Rajchgot, MD, J. Mayer, PhD, Hilary Whyte, MB, Karen Pape, MD and Stuart M. MacLeod, MD, PhD

Divisions of Clinical Pharmacology (Drs. Koren, Rajchgot, and MacLeod) and Neonatology (Drs. Butt, Whyte, and Pape), The Research Institute, The Hospital for Sick Children, and from the Ontario Centre for Forensic Science (Dr. Mayer), Toronto, Ontario, Canada.

We studied 14 newborn infants with seizures after birth asphyxia or other causes. Paraldehyde was given as a 200 mg/kg IV bolus followed by an infusion of 16 mg/kg/h (10 cases), or as a 400 mg/kg bolus (4 cases). Serum concentrations of paraldehyde were higher in periods of adequate seizure control than in periods of little or no response. Paraldehyde serum concentrations above 10 mg/dl were associated with anticonvulsant effects and were achieved in most neonates with a 2-hour infusion of 200 mg/kg/h. If there is no effect, serum concentrations are probably below 10 mg/dl and an additional 200 mg/kg can be given safely over 1 hour.

Address correspondence and reprint requests to Dr. Koren, Division of Clinical Pharmacology, The Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada M5G 1X8.

Dr. Gideon Koren is a fellow of the Medical Research Council of Canada.

Accepted for publication April 18, 1985.




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