title: 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.
authors.affiliation: Kork Epilepsy Center, Kehl, Germany.
authors.forename: Thomas
authors.initials: T
authors.lastname: Bast
authors.affiliation: Department of Neuropediatrics, University Medical Center Schleswig-Holstein (UKSH, Campus Kiel), Kiel, Germany.
authors.forename: Sarah
authors.initials: S
authors.lastname: Richter
authors.affiliation: Pediatric Clinic, St. Vincenz Hospital, Paderborn, Germany.
authors.forename: Friedrich
authors.initials: F
authors.lastname: Ebinger
authors.affiliation: Dr. Rating was previously associated with University Children's Hospital, Heidelberg, Germany. He has now retired.
authors.forename: Dietz
authors.initials: D
authors.lastname: Rating
authors.affiliation: Kork Epilepsy Center, Kehl, Germany.
authors.forename: Adelheid
authors.initials: A
authors.lastname: Wiemer-Kruel
authors.affiliation: University Children's Hospital, Heidelberg, Germany.
authors.forename: Susanne
authors.initials: S
authors.lastname: Schubert-Bast
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D004827:Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008775:Methylprednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D020551:Pulse Therapy, Drug; D012189:Retrospective Studies; D016896:Treatment Outcome
chemical_list: D008775:Methylprednisolone