Abstracts

Rationale: Steroids have been used for the treatment of certain epilepsy syndromes, such as infantile spasms; however, the use in the treatment of other intractable epilepsies has received limited study. We report our experience with intravenous methylprednisolone in children with epilepsy refractory to multiple antiepileptic drugs. Methods: Series of consecutive children were included retrospectively. Patients with infantile spasms, progressive degenerative or metabolic disorders were excluded. Results: Seventeen children aged 2-14 (mean 5.3) years were included. Associated cognitive and motor deficits were recognized in 82%. Most children (88%) had daily seizures and 13 (76%) were admitted previously with status epilepticus. The epilepsy was cryptogenic (unknown etiology) in 47% and the seizures were mixed in 41%. Intravenous methylprednisolone was given at 15 mg/kg/day followed by a weaning dose of oral prednisolone for 2-8 weeks (mean 3). Children were followed for 6-24 months (mean 18). Six (35%) children became completely seizure free; however, 3 of them later recurred. At 6 months post-treatment, improved seizure control was noted in 10 (59%) children. Patients with mixed seizures were more likely to have a favorable response when compared to those with one seizure type (49% vs 31%, p=0.02). No major side effects were noted and 35% of the parents reported improvements in their child's alertness and appetite. Conclusions: Add-on steroid treatment for children with intractable epilepsy is safe and effective when used in a short course.