Efficacy and tolerability of methylprednisolone pulse therapy in childhood epilepsies other than infantile spasms

• Verfasst von: Bast, Thomas [VerfasserIn]
• Verfasst von: Rating, Dietz [VerfasserIn]
• Verfasst von: Schubert-Bast, Susanne [VerfasserIn]
• Titel: Efficacy and tolerability of methylprednisolone pulse therapy in childhood epilepsies other than infantile spasms
• Verf.angabe: Thomas Bast, Sarah Richter, Friedrich Ebinger, Dietz Rating, Adelheid Wiemer-Kruel, Susanne Schubert-Bast
• E-Jahr: 2014
• Jahr: 03. September 2014
• Umfang: 8 S.
• Fussnoten: Gesehen am 14.10.2020
• Titel Quelle: Enthalten in: Neuropediatrics
• Ort Quelle: Stuttgart [u.a.] : Thieme, 1969
• Jahr Quelle: 2014
• Band/Heft Quelle: 45(2014), 06, Seite 378-385
• ISSN Quelle: 1439-1899
• DOI: doi:10.1055/s-0034-1387817
• Datenträger: Online-Ressource
• Sprache: eng
• K10plus-PPN: 1735525146

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.