Abstract
15 children with variable intractable seizure disorders who were on multiple anti-convulsant medications were treated with pulse monthly doses of parentral dexamethsone varying from 4 – 7 months. EEG and clinical response were assessed periodically as well at the end of the study. 53% of the patients showed clinical response and EEG response. Hypertension was noted in 6, hypokalemia in 3 and hyperglycaemia in 1 patient. The ultimate compliance from the parents for this treatment was seen among 12 patients because of its proven efficacy and parents of seven patients insisted to continue the treatment for long duration.
Highlights
Epilepsy is a common problem in children which is treatable
Some patients are difficult to treat which was previously called intractable epilepsy and it varies from 6- 40% in many studies. [1,2] International League Against Epilepsy (ILAE-2010) defines drug resistant epilepsy (DRE) as failure of adequate trial of two tolerated and appropriately chosen and used anti epileptic drugs schedules to achieve sustained seizure freedom.[1]
There were few reports of pulsatile corticosteroid, as an alternative to adrenocortciotrophic hormone (ACTH) in such intractable seizure disorders in children and its efficacy as well safety.[7,8].We report here a retrospective study of efficacy and adverse side effects of pulsatile dexamethasone in the treatment of childhood intractable epileptic disorders
Summary
Corticosteroids, either as adrenocortciotrophic hormone (ACTH) or synthetic preparations of steroids have been used widely for the treatment of intractable epileptic disorders of childhood since long time. Livingston and Sorel reported the benefits of ACTH in West syndrome , an infantile form of epileptic encephalopathy.[4,5] Since numerous studies have been done regarding wide usage of corticosteroid in different preparations in therapy-resistant epilepsies of childhood there is no consensus opinion regarding their efficacy.[4,5]. There were few reports of pulsatile corticosteroid, as an alternative to ACTH in such intractable seizure disorders in children and its efficacy as well safety.[7,8].We report here a retrospective study of efficacy and adverse side effects of pulsatile dexamethasone in the treatment of childhood intractable epileptic disorders
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