Efficacy and prognosis of a short course of prednisolone therapy for pediatric epilepsy

Effectiveness of a hybrid corticosteroid treatment regimen on refractory childhood seizures and a review of other corticosteroid treatments

“…The most effective prednisolone regimen for Duchenne patients appears to be 0.75 mg/kg/day in a daily administration, which is comparable to the dosage used in this study. 35,36 Our results (43% good response) compare unfavourably with results of You et al 27 (79% good response) and Sinclair et al 18 (81% good response). The lower effectiveness of our treatment regimen may not only be due to the relatively low maintenance dosage of prednisolone, but also because the nature of the studied population.…”

“…Other reported side effects are irritability, Cushing syndrome, hyperglycaemia, hypokalaemia, higher risk for infections, and dilatation of ventricular and subarachnoid spaces. 18,26,27 Serious adverse events like infections and sepsis and cardiomyopathy predominantly occurred with the use of ACTH. 1,32e34 The longterm use of corticosteroids in Duchenne patients commonly had adverse effects, although clinically mild.…”

“…In a study by Sevilla et al methylprednisolone in pulse therapy during three days per month for 12 weeks resulted in a very high 'good response rate' of 83%, but only 17% of patients became seizure free and also in this group relapse occurred in all but one patient. 28 Kramer and colleagues were the first to use a pulse of methylprednisolone in 29 Dexamethasone, 3 d 0.5 mg/kg/d once a month 6 12 Unclassified 6 (100%) 1 (17%) 0 (0%) J Verhelst 29 Hydrocortisone, 20 mg/kg/d 5 24 Unclassified 4 (80%), LGS 1(20%) 4 (80%) 1 (20%) K You 27 Prednisolone, 6 w 2 mg/kg/d, 2 w taper combination with prednisone, to which 30% of patients responded well. 23 Verhelst et al described that four of five patients became seizure free with prolonged hydrocortisone treatment.…”

“…26 Treatment with prednisone resulted in a good response in 38e81% of the patients treated and 60% became seizure free. 18,23,27 In 75% of the latter, however, relapse from seizure freedom occurred. A recent report by Bast 4 et al showed a good response in about one third of patients with refractory seizures treated with weekly methylprednisolone pulses, while 75% of patients with CSWS showed good response.…”

Intravenous methylprednisolone pulse therapy for children with epileptic encephalopathy

“…Lichtenfeld et al (2010) reported a significant reduction in EEG abnormalities in a girl presenting with absence seizures treated with a pulse therapy regimen. Although literature reports have indicated a high relapse rate in patients with epileptic encephalopathy (44-70% within 3-6 months) (Sinclair, 2003;Gupta and Appleton, 2005;Verhelst et al, 2005;Okumura et al, 2006;You et al, 2008), this was not confirmed by the present study. There are several theories regarding the mechanism of action of corticosteroids in epilepsy.…”