High-Dose Intravenous Immunoglobulin Treatment in Intractable Childhood Epilepsy
Rationale: Intractable childhood epilepsy is characterised by convulsions, which are resistant to treatment with adequate dosage, combination and duration of appropriate anticonvulsant drugs. Many clinical and experimental studies support the role of the immune mechanism in the pathogenesis of childhood epilepsy. The purpose of the present study is to ascertain the possible efficacy of intravenous immunoglobulin in the treatment of intractable childhood epilepsy. Methods: The children aged 4-8 years suffering from intractable childhood epilepsy were treated with high-dose intravenous immunoglobulin (400 mg/kg) 5 times in the first week, on the 15th and 30th days. The treatments were repeated every 4 weeks for 6 months. The cases were as follows: infantile or epileptic spasms (5 cases), myoclonic epilepsy (1 case), secondary generalised simple partial seizure (1 case), secondary generalised complex partial seizure (1 case), and myoclonic absence (2 cases). The cases were followed up for 6 months to 2 years. Clinical examinations, electroencephalograms and computed tomography findings were evaluated in all cases. Response to treatment was evaluated by estimating the reduction in clinically observed seizures. Results: One child had complete remission, 2 had partial response with 75% reduction in seizure frequency, 3 had 50% reduction in seizure frequency and the remaining 4 cases had no response. There were no side effects due to intravenous immunoglobulin administration. Conclusions: We conclude that intravenous immunoglobulin is a safe therapy and may have beneficial effects in intractable epilepsies, but controlled, multicentre studies are needed to elucidate the pathogenesis and the effects of this therapy.
High-Dose Intravenous Immunoglobulin Treatment in Intractable Childhood Epilepsy
Rationale: Intractable childhood epilepsy is characterised by convulsions, which are resistant to treatment with adequate dosage, combination and duration of appropriate anticonvulsant drugs. Many clinical and experimental studies support the role of the immune mechanism in the pathogenesis of childhood epilepsy. The purpose of the present study is to ascertain the possible efficacy of intravenous immunoglobulin in the treatment of intractable childhood epilepsy. Methods: The children aged 4-8 years suffering from intractable childhood epilepsy were treated with high-dose intravenous immunoglobulin (400 mg/kg) 5 times in the first week, on the 15th and 30th days. The treatments were repeated every 4 weeks for 6 months. The cases were as follows: infantile or epileptic spasms (5 cases), myoclonic epilepsy (1 case), secondary generalised simple partial seizure (1 case), secondary generalised complex partial seizure (1 case), and myoclonic absence (2 cases). The cases were followed up for 6 months to 2 years. Clinical examinations, electroencephalograms and computed tomography findings were evaluated in all cases. Response to treatment was evaluated by estimating the reduction in clinically observed seizures. Results: One child had complete remission, 2 had partial response with 75% reduction in seizure frequency, 3 had 50% reduction in seizure frequency and the remaining 4 cases had no response. There were no side effects due to intravenous immunoglobulin administration. Conclusions: We conclude that intravenous immunoglobulin is a safe therapy and may have beneficial effects in intractable epilepsies, but controlled, multicentre studies are needed to elucidate the pathogenesis and the effects of this therapy.
