Successful treatment of seizure disorder by evaluating phenobarbital clearance in a paediatric patient undergoing continuous haemodiafiltration.

WHAT IS KNOWN AND OBJECTIVE: Determination of phenobarbital (PB) dosing during continuous haemodiafiltration (CHDF) requires evaluation of both the patient's own clearance and CHDF clearance.

CASE DESCRIPTION: Systemic clearance of PB in a 9-year-old female patient with Dravet syndrome, who was undergoing CHDF, was calculated by the Sawchuk-Zaske method, and clearance by CHDF was calculated as the difference between PB levels in influx and efflux, adjusted for the blood purification conditions. Dosage adjustment produced seizure control.

WHAT IS NEW AND CONCLUSION: Adjusting PB dose by evaluating the patient's own PB clearance as well as that by CHDF resulted in accurate control of PB level and a reduction in the occurrence of seizures.