AN EARLIER study showed that diphenylhydantoin must attain a certain concentration in the serum if seizures are to be controlled and paroxysmal activity in the electroencephalogram (EEG) diminished1; thus, the serum level of diphenylhydantoin is an important guide to proper dosage. The relation between the dose of phenobarbital and its effect is difficult to assess clinically because three to five weeks elapse from the onset of medication until a constant serum concentration is reached.2 In the study reported here the correlation between the concentration of phenobarbital in the serum, the incidence of paroxysmal abnormalities in the EEG, and the anticonvulsant effect was investigated in patients with grand mal seizures.
The study was comprised of 13 hospitalized patients; seven females and six males, the criterion of selection being a high incidence of paroxysmal activity in the EEG. Twelve patients had grand mal, 11 as the sole form
Buchthal F, Svensmark O, Simonsen H. Relation of EEG and Seizures to Phenobarbital in Serum. Arch Neurol. 1968;19(6):567–572. doi:10.1001/archneur.1968.00480060037004