title: Intravenous methylprednisolone for intractable childhood epilepsy.
abstract: BACKGROUND
  Steroids have been used for the treatment of certain epilepsy types, 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
  A series of consecutive children were analyzed 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 per day followed by a weaning dose of oral prednisolone for 2-8 weeks (mean 3 weeks). Children were followed for 6-24 months (mean 18). Six (35%) children became completely seizure free; however, three of them later developed recurrent seizures. At 6 months posttreatment, improved seizure control was noted in 10 (59%) children. Children with mixed seizures were more likely to have a favorable response than 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 may be effective in some children when used in a short course.
authors: Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors: Kholoud H
authors: KH
authors: Almaabdi
authors: Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors: Rawan O
authors: RO
authors: Alshehri
authors: Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors: Areej A
authors: AA
authors: Althubiti
authors: Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors: Zainab H
authors: ZH
authors: Alsharef
authors: Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors: Sara N
authors: SN
authors: Mulla
authors: Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors: Dareen S
authors: DS
authors: Alshaer
authors: Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia.
authors: Nouf S
authors: NS
authors: Alfaidi
authors: Department of Pediatrics, Faculty of Medicine, King Abdulaziz University, Jeddah, Saudi Arabia. Electronic address: mmjan@kau.edu.sa.
authors: Mohammed M
authors: MM
authors: Jan
mesh_terms: D061605:Administration, Intravenous; D000293:Adolescent; D000927:Anticonvulsants / Q000008:administration & dosage*; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage*; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants; D008775:Methylprednisolone
keywords: child; epilepsy; intractable; methylprednisolone; seizure