title: Efficacy of intravenous immunoglobulin in a cohort of children with drug-resistant epilepsy.
abstract: OBJECTIVE
  We describe the experience of a pediatric epilepsy center regarding the efficacy of intravenous immunoglobulin for drug-resistant seizures in children.
  
  
  METHODS
  A retrospective chart review of all children in a community-based, children's hospital neurology clinic from 2006 to 2012, inclusive, with intractable epilepsy who were treated with intravenous immunoglobulin for a minimum of six cycles was performed. Data collected included patient demographics, seizure and epilepsy syndrome type, presumed etiology for the seizures, and seizure frequency. Response to intravenous immunoglobulin was defined as "positive" if either seizure freedom or ≥50% reduction of seizures was achieved.
  
  
  RESULTS
  Twenty-seven children (3-17 years old) were identified and included in the analysis. Following treatment with intravenous immunoglobulin, the following outcomes were noted: four were seizure-free, eight had 90% reduction, five had 75% reduction, and five had 50% reduction. A total of 22 (81%) patients had a positive clinical response to treatment from baseline. Five patients (19%) were not responsive. No clear relationship of responsiveness to intravenous immunoglobulin with regard to age, gender, or epilepsy syndrome was apparent; however, the small numbers in each category precluded meaningful statistical analysis.
  
  
  CONCLUSIONS
  Our findings and those of others suggest that intravenous immunoglobulin is a potentially high efficacy, low side effect profile therapy in the treatment of children with drug-resistant epilepsies. Intravenous immunoglobulin was able to reduce multiple seizure types in a variety of epilepsy etiologies, including those of unknown cause.
authors.affiliation: Department of Pediatrics, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
authors.forename: Luis E
authors.initials: LE
authors.lastname: Bello-Espinosa
authors.affiliation: Department of Pediatrics, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
authors.forename: Thilinie
authors.initials: T
authors.lastname: Rajapakse
authors.affiliation: Department of Pediatrics, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada.
authors.forename: Jong M
authors.initials: JM
authors.lastname: Rho
authors.affiliation: Department of Pediatrics, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada; Department of Clinical Neurosciences, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada; Alberta Children's Hospital Research Institute, University of Calgary Faculty of Medicine, Calgary, Alberta, Canada. Electronic address: jeffrey.buchhalter@albertahealthservices.ca.
authors.forename: Jeffrey
authors.initials: J
authors.lastname: Buchhalter
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D015331:Cohort Studies; D000069279:Drug Resistant Epilepsy / Q000188:drug therapy*; D005260:Female; D006801:Humans; D016756:Immunoglobulins, Intravenous / Q000627:therapeutic use*; D007155:Immunologic Factors / Q000627:therapeutic use*; D008297:Male; D016896:Treatment Outcome
chemical_list: D016756:Immunoglobulins, Intravenous; D007155:Immunologic Factors
keywords: IVIG; child; drug-resistant epilepsy; intravenous immunoglobulin; seizures