title: Corticosteroids including ACTH for childhood epilepsy other than epileptic spasms.
abstract: BACKGROUND
  This is an updated version of the original Cochrane review published in Issue 1, 2007.Epilepsy is a disorder with recurrent epileptic seizures. Corticosteroids have been used in the treatment of children with epilepsy and have significant adverse effects. Their efficacy and tolerability have not been clearly established.
  
  
  OBJECTIVE
  To determine the efficacy, in terms of seizure control, improvements in cognition and in quality of life and tolerability of steroids compared to placebo or other antiepileptic drugs in children with epilepsy, excluding epileptic spasms.
  
  
  METHODS
  We searched the following databases: The Cochrane Epilepsy Group Specialized Register (1 August 2014); CENTRAL, (The Cochrane Library Issue 7, July 2014); MEDLINE (1946 to 1 August 2014); EMBASE (1966 to December 2004); Database of Abstracts of Reviews of Effectiveness (DARE; Issue 3 of the database published in The Cochrane Library Issue 7, July 2014); ClinicalTrials.gov and the WHO International Clinical Trials Registry Platform ICTRP (1 August 2014).We checked the reference lists of retrieved studies for additional reports of relevant studies.
  
  
  METHODS
  All randomised controlled trials of administration of corticosteroids to children (less than 16 years) with epilepsy.
  
  
  METHODS
  For this update two review authors independently selected trials for inclusion and extracted data. Outcomes included cessation of seizures, reduction in seizure frequency, improvement in cognition, quality of life and adverse effects of steroids.
  
  
  RESULTS
  A single RCT was included that recruited five children in a double blind cross-over trial. One child was withdrawn prematurely from the study and another had infantile spasms and hence was excluded from further analysis. Adrenocorticotrophin hormone (ACTH 4-9) was administered. Of the three children analysed, one showed a reduction in seizures of 25% to 50% at both the low and higher doses of corticosteroids compared to placebo; one child showed a reduction in seizures at the higher dose only and one child showed no reduction in seizures at either dose. No adverse effects were reported.
  
  
  CONCLUSIONS
  Since the last version of this review no new evidence has been found for the efficacy of corticosteroids in treating childhood epilepsies. Clinicians using steroids in childhood epilepsies, other than for epileptic spasms, should take this into account before using these agents.
authors.affiliation: Department of Paediatrics, Hull and East Yorkshire Hospitals NHS Trust, Anlaby Road, Hull, West Yorkshire, UK, HU3 2JZ.
authors.forename: Vishal
authors.initials: V
authors.lastname: Mehta
authors.forename: Colin D
authors.initials: CD
authors.lastname: Ferrie
authors.forename: J Helen
authors.initials: JH
authors.lastname: Cross
authors.forename: Gayatri
authors.initials: G
authors.lastname: Vadlamani
mesh_terms: D000305:Adrenal Cortex Hormones / Q000627:therapeutic use*; D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use*; D002648:Child; D004827:Epilepsy / Q000188:drug therapy*; D006801:Humans; D016032:Randomized Controlled Trials as Topic
chemical_list: D000305:Adrenal Cortex Hormones; D000927:Anticonvulsants; D000324:Adrenocorticotropic Hormone