title: Intravenous immunoglobulin therapy in intractable childhood epilepsy: open-label study and review of the literature.
abstract: Our aim was to investigate the long term effectiveness of intravenous immunoglobulin (IVIG) against intractable childhood epilepsy in the era of new antiepileptics and to determine the predictors of a favorable response in a prospective open-label add-on study. Of thirty-seven 9.9+/-0.9-year-old patients (11 with partial seizures, 26 with generalized seizures of whom 9 had West syndrome and 17 Lennox-Gastaut syndrome) followed for 15+/-3 months, 43% had a >50% decrease in seizures (including 15% seizure free, 229+/-58 compared with 104+/-3 seizures/month, P=0.035: generalized 246+/-318 to 117+/-200, P=0.025, partial 191+/-437 to 72+/-179, P>0.05; power=0.2). Males were more likely to respond than females (P=0.011, odds ratio=9.3). Review of the literature revealed nine other articles reporting efficacy of IVIG against epileptic seizures. Only one other used statistical methods and, unlike ours, showed only a trend toward seizure frequency reduction without achieving statistical significance, presumably because it was underpowered. These results indicate large-scale controlled studies of IVIG in epilepsy are still needed.
authors.affiliation: Adult and Pediatric Epilepsy Program, Department of Pediatrics and Adolescent Medicine, American University of Beirut Medical Center, Beirut, Lebanon. mohamad.mikati@duke.edu
authors.forename: Mohamad A
authors.initials: MA
authors.lastname: Mikati
authors.forename: Rana
authors.initials: R
authors.lastname: Kurdi
authors.forename: Ziad
authors.initials: Z
authors.lastname: El-Khoury
authors.forename: Amal
authors.initials: A
authors.lastname: Rahi
authors.forename: Wissam
authors.initials: W
authors.lastname: Raad
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000145:classification / Q000188:drug therapy* / Q000503:physiopathology; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000008:administration & dosage*; D007155:Immunologic Factors / Q000008:administration & dosage*; D008137:Longitudinal Studies; D008297:Male; D015999:Multivariate Analysis; D055815:Young Adult
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors