小児癩癇に対するPhenylacetyl ureaの使用成績

Use of Phehylacetylnrea in the Treatment of Epilepsy of Infants and Children

I．緒言

　1948年，Spielman^1）により合成され，Everett²等によつてその抗痙攣作用が認められたPhe-nylacetyl urea　（Phenacemide, Phenurone）．は，其の後Gibbs^3），Davidson^4），Livingston^5）等により臨床実験が行われ，主として精神運動発作に効果がある薬剤と認められ，我が国でも既にいくつかの報告がなされている^6）7）8）。しかしながら，之を小児，特に3歳以下の乳幼児の多数例に使用した報告は極めて少く，副作用の検討も又殆んどなされていない。

　我々は昭和29年来痙攣を主訴として当科外来を訪れた患児の中，従来特に予後の悪いとされるLivingston^9）のいう小運動発作（minor motorSeizure）及び全身性大発作，焦天性発作で他の薬剤の効果が認められなかつた例に，Phenylacetylureaを投与し，臨床的，脳波的に効果を検討し，併せて副作用に就いて考察し，2〜3の知見を得たので報告する次第である。

The effects of Phenylacetyl urea in the treatment of forty-four epilepsy patients of infants and children are discussed.

Seizure types were classified into three groups-generalized grand mal type, localized grand mal type and minor motor seizures-in accordance with the classification of Livings-ton.

Twenty of twenty-three patients of less than three years, including all of 10 cases under one year, showed minor motor seizures.

Of the forty-four cases, thirteen patients among whom eleven were under three years old had been treated very effectively, and attacks were suppressed completely.

Concluded from this result, Phen glacetyl urea is very effective in some cases in the management of infantile epilepsy, especially of minor motor seizures which show frequently so-called hypsarhythmia and petit mal variant in E.E.G.

The toxicity of this agent is discussed.

Slight side effects were noticed, but we could continue to use it for three months or leven months without any severe side effect, except four cases who had shown leucopenia, albuminuria and slight liver damage.