フェニトイン継続投与による耳鳴の治療

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  • Therapeutic Effect of Continuous Administration of Phenytoin in Patients with Tinnitus.

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Thirty-two patients with tinnitus who had not responded to other treatments were given weekly I. V. injections of phenytoin. They were 19 males and 13 females aged 35 to 73 years (mean 63).<br>The drug (125 mg) was dissolved in physiological saline (100 ml) and infused intravenously once a week four to twelve times.<br>The pre-treatment severity of tinnitus was graded 10, and the patients were asked to score their subjective assessment of the effect by venous of the treatment immediately after administration and the duration of the effect. Scores of 0-2 were defined as “very effective”, scores of 3-6 as “effective”, scores of 7 and 8 as “slightly effective” and scores of 9 and 10 as “ineffective”. They were also asked to score their degree of satisfaction with this therapy.<br>This treatment was reported to be effective (score of 6 or lower) in approximately 80% of the patients who received eight infusions.<br>In 21 (66%) of the 32 patients, the first treatment had some effect, and the scores decreased as the therapy was repeated. Patients with scores of 6 or lower were more satisfied than those with scores of 7-10.<br>No relationship was found between the duration of the effect and the score.<br>Even most patients who failed to respond to the first infusion reported improvement by the fourth or fifth infusion. We conclude that four phenytoin treatments would be effective in most patients. For those who fail to respond it could be offered up to four more times, and if there is still no improvement, it should be judged to be ineffective.

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