[Prednisolone therapy in refractory childhood epilepsy]

Steroids are effective medicaions for controlling the infantile spasms, but there have been few reports of steroid effect in other childhood epileptic syndromes, especially refractory syndromes. The objective of this study was to determine the efficacy of prednisolone in 35 children with intractable epilepsy. This prospective, uncontrolled study was undertaken at the Mofid paediatric Hospital from September 2004 to September 2005. Thirty five children [12 girls and 23 boys], aged bteween 1 to 12 years old with intractable epilepsy were enrolled. Prednisolone [1 mg/kg/day] was prescribed for 12 weeks [Once a day for 6 weeks follwed by every other day for another 6 weeks] in addition to their regular antiepileptic medications. The parents kept seizure diaries. After 1 year of follow up, 17 patients [49%] became seizure-free on prednisolone, whereas another 8 [23%] experienced a significant decreases more than 50% in seizure frequency. In contrast, ten patients [28%] had no changes in seizure frequency. The best response were seen in idiopathic epilepsy [95%] and atypical absence ones [86%]. The least therapeutic effect was seen in symptomatic myoclonic epilepsy [54%]. Side effects such as behavioral disturbances, weight gain and gastrointestinal bleeding were developed in 8 patients and also 14 patients were found to have cushingoid face. All the side effects were regressed after drug discontinuation Prednisolone therapy is a safe and effective adjunctive treatment for children with intractable epilepsy and it should be considered as an alternative treatment for older children with refractory epilepsy