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Efficacy and tolerability of methylprednisolone pulse therapy in childhood epilepsies other than infantile spasms.

Abstract
This retrospective study included 54 children with epilepsy. The treatment consisted of four pulses with single doses of 20 mg/kg/d methylprednisolone (MPR), administered every week on 3 consecutive days. After this initial phase, the intervals between the pulses were increased based on individual factors. MPR pulses were administered exclusively orally in 39 patients and 7.8% of all pulses were applied intravenously. After four pulses, 30 of 54 (56%) patients were responders, according to several clinical and electroencephalography criteria. A response was obtained in 12 of 20 (60%) cases with genetic, 7 of 17 (41%) with structural metabolic, and 11 of 17 (65%) with unknown etiology. Responder rates were 11 of 15 (73%) in patients with continuous spike-waves in slow sleep (CSWS) or Landau-Kleffner syndrome, 2 of 6 in patients with myoclonic astatic epilepsy or Lennox-Gastaut syndrome, and 17 of 31 (55%) in patients with unclassified epilepsies. A response was not correlated with any epilepsy-related clinical factor. The patients received a median of eight MPR pulses (range, 1-52), and the median duration of the therapy was 11 weeks. The response was maintained in 19 of 30 (63%) patients, and 3 of 24 (13%) without initial response became seizure-free (total responder rate at the end of the therapy 22/54 [41%]). The majority of patients experienced adverse effects that were typically mild and transient.
AuthorsThomas Bast, Sarah Richter, Friedrich Ebinger, Dietz Rating, Adelheid Wiemer-Kruel, Susanne Schubert-Bast
JournalNeuropediatrics (Neuropediatrics) Vol. 45 Issue 6 Pg. 378-85 (Dec 2014) ISSN: 1439-1899 [Electronic] Germany
PMID25184741 (Publication Type: Journal Article)
CopyrightGeorg Thieme Verlag KG Stuttgart · New York.
Chemical References
  • Methylprednisolone
Topics
  • Adolescent
  • Child
  • Child, Preschool
  • Epilepsy (drug therapy)
  • Female
  • Humans
  • Infant
  • Male
  • Methylprednisolone (administration & dosage, adverse effects)
  • Pulse Therapy, Drug
  • Retrospective Studies
  • Treatment Outcome

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