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Objective: To examine the causes of sequelae or death of patients who presented them subsequently to seizures that developed during theophylline administration., Methods: Among 334 patients who had been examined in Study (I), we extracted 56 who had sequelae or died subsequently to the onset of seizures and examined their causes., Results: Many patients had fever at the onset of seizures, many patients had neurologic predispositions prior to seizure onset, and only one patient was found to be free from fever and neurologic findings. At the onset of seizures, most of these patients had blood theophylline concentrations that were within or inferior to the target range (5-15 microg/mL)., Conclusions: We presume it necessary to pay heed to fever and neurologic predispositions in order to prevent sequelae or death that may occur subsequently to seizures that developed during theophylline administration.

Objectives: To discover features of patients with theophylline toxicosis among patients who developed convulsions during theophylline administration., Methods: Fifteen patients, whose measured or estimated blood theophylline concentration at the time of convulsion development was >/=40 microg/mL, were extracted out of 334 patients who were reported between October 1987 and April 2004 and who developed convulsions during theophylline administration (oral theophylline: 255 patients; intravenous theophylline: 79 patients). Patient background, state of drug administration, blood theophylline concentration, presence or absence of status epilepticus, and outcome were examined., Results: Young children and children with fever were predominant, and eight of 15 patients had both features. Furthermore, the dose exceeded the currently recommended target dose in most of patients whose given dose is known. Patients with misdispensing and patients having problems with administration and ingestion methods were included in them. Outcomes included one case of death, two cases of sequelae, 11 cases of recovery or alleviation, and 1 case of unknown. The patient who died took large doses of theophylline, and both of two patients who had sequelae had fever associated with an infection., Conclusions: Our study revealed 1) heed should be given to the age of the affected child and to theophylline administration when fever is present in order to avoid theophylline toxicosis and 2) many patients with the toxicosis (11/15) present a relatively favorable prognosis.