Thirty-six children with
epilepsy resistant to conventional treatment were treated with
bromides in addition to the current
therapy. Six out of 19 cases with prevailingly or exclusively
generalized tonic-clonic seizures became seizure-free and in 9 cases a reduction in seizure frequency of more than 50% was achieved. Freedom from
seizures could not be obtained in 13 cases, who had frequent minor
seizures in addition to
generalized tonic-clonic seizures. In some, minor
seizures were even activated. Tonic and
focal seizures showed no response. Side effects were observed in one-third of the cases (
acne, loss of appetite, loss of weight,
fatigue) but in no case they did become intolerable. Fifty to 80 mg
potassium bromide per kg
body weight seems to be an effective daily dose range. There is a preferential indication of
bromides for patients suffering from early onset
epilepsy with
generalized tonic-clonic seizures and/or alternating hemi-grand mal, for whom other treatment is ineffective. This disorder is characterized by a high familial incidence of epileptic
seizures, onset between 6 months and 3 years of age, normal development until the onset of
seizures, generalized tonic-clonic seizures and often alternating hemi-grand mal, seizure precipitation by
fever, and occasional combination with or transition to myoclonic-astatic and/or
myoclonic seizures. EEG is often normal or shows slight slowing in the initial phase; later it shows theta rhythms and generalized spikes and waves. Especially, if the onset is during the first year of life, the course of the
epilepsy is often unfavourable.