Abstract
References
- Poonam Nina B.,David F,W Allen H. The descriptive epidemiology of epilepsy-a review Epilepsy Res.2009; 85(1): 31–45. https://doi.org/10.1016/j.eplepsyres.2009.03.003
- Kwan P, Arzimanoglou A, Berg AT, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc task force of the ILAE commission on therapeutic strategies. Epilepsia. 2010;51(6):1069‐1077. doi: 10.1111/j.1528-1167.2009.02397.
- Mohanraj R, Brodie MJ. Outcomes of newly diagnosed idiopathicgeneralized epilepsy syndromes in a non-pediatric setting. Acta NeurolScand. 2007;115(3):204–208. doi: 10.1111/j.1600-0404.2006.00791
- Szaflarski JP, Lindsell CJ, Zakaria T, Banks C, Privitera MD. Seizure control in patients with idiopathic generalized epilepsies:EEG determinants of medication response. Epilepsy Behavior.2010;17(4):525–530. doi:10.1016/j.yebeh.2010.02.005
- Mohanraj R., Brodie M.J.: Early predictors of outcome in newly diagnosed epilepsy. Seizure 2013; 22: pp. 333-344. doi: 10.1016/j.seizure.2013.02.002.
- Heida JG, Pittman QJ. Causal links between brain cytokines and experimental febrile convulsions in the rat. Epilepsia. (2005) 46:1906– 13. doi: 10.1111/j.1528-1167.2005.00294
- Van Vliet EA, Aronica E, Vezzani A, Ravizza T. Review: neuroinflammatory pathways as treatment targets and biomarker candidates in epilepsy: emerging evidence from preclinical and clinical studies. Neuropathol Appl Neurobiol. 2018; 44:91–111 doi: 10.1111/nan.12444.
- Orsini A, Foiadelli T, Costagliola G, Michev A, Consolini R, Vinci F, et al. The role of inflammatory mediators in epilepsy: focus on developmental and epileptic encephalopathies and therapeutic implications. Epilepsy Res. 2021; 172:106588. doi: 10.1016/j.eplepsyres.2021.106588.
- Nylander A., Hafler D.A. Multiple sclerosis. J. Clin. Invest. 2012;122 doi: 10.1172/JCI58649
- Ong M.-S., Kohane I.S., Cai T., Gorman M.P., Mandl K.D. Population-Level Evidence for an Autoimmune Etiology of Epilepsy. JAMA Neurol. 2014; 71:569–574.
- Meng F., Yao L. The role of inflammation in epileptogenesis. Acta Epileptol. 2020; 2:15.
- Aykut-Bingol C, Arman A, Tokol O, et al. Pulse methylprednisolone therapy in Landau-Kleffner syndrome. 1996; J Epilepsy 9:189-191.
- Tsuru T, Mori M, Mizuguchi M, et al. Effects of high-dose intravenous corticosteroid therapy in Landau-Kleffner syndrome. 2000; Pediatr Neurol 22:145-147. doi: 10.1016/s0887-8994(99)00127-7.
- Okuyaz C, Aydin K, Gücüyener K, et al. Treatment of electrical status epilepticus during slow-wave sleep with high-dose corticosteroid. 2005; Pediatr Neurol 32:64-67. doi: 10.1016/j
- Sevilla-Castillo RA, Palacios GC, Ramirez-Campos J, et al. Methylprednisolone for the treatment of children with refractory epilepsy. 2009; Neuropediatrics 40:265-268. doi:10.1055/s-0030-1249653
- Lichtenfeld R, Heyman E, Gandelman-Marton R, et al. Intravenous methylprednisolone pulse therapy in a young girl with intractable absence seizures. 2010. Isr Med Assoc J 12:181-182
- Mytinger JR, Quigg M, Taft WC, et al (2010). Outcomes in treatment of infantile spasms with pulse methylprednisolone. J Child Neurol 25:948-95. doi:10.1177/08830 73809356107.
- Heyman E, Lahat E, Gandelman-Marton R . Interictal encephalography can influence patient selection for methylprednisolone therapy in pediatric refractory epilepsy. 2012; J Child Neurol 27:162-167. doi:10.1177/0883073811414905
- Almaabdi KH, Alshehri RO, Althubiti AA, et al. Intravenous methylprednisolone for intractable childhood epilepsy. Pediatr Neurol. 2014; 50:334-336. doi: 10.1016/j.
- Marchi N, Granata T, Freri E, et al. Efficacy of anti-inflammatoryütherapy in a model of acute seizures and in a populationof pediatric drug resistant epileptics. PLoS One. 2011; 28;6(3):e18200. 6:e18200.doi: 10.1371/journal.pone.0018200.
- Vezzani A, Granata T. Brain inflammation in epilepsy:experimental and clinical evidence. Epilepsia. 2005; 46:1724-1743. doi: 10.1111/j.1528-1167.2005.00298
- Özkara Ç, Vigevano F. Immuno- and antiinflammatory therapies in epileptic disorders. Epilepsia. 2011; 3:45-51. doi:10.1111/j.1528-1167.2011.03036
- Bien CG, Urbach H, Schramm J, et al. Limbic encephalitis as a precipitating event in adult-onset temporal lobe epilepsy. Neurology 2007; 69:1236–1244. doi: 10.1212/01.wnl.0000276946.08412.ef.
- Maria Carmela Pera,Giovanna Randazzo,Silvia Masnada,et al. Intravenous methylprednisolone pulse therapy for children with epileptic encephalopathy. Functional Neurology 2015; 30(3): 173-179. doi:10.11138/fneur/2015.30.3.173
Abstract
Objective:
Epilepsy is an important neurological disorder with serious consequences for both patients and society. Even though most cases of epilepsy can be controlled with antiseizure drugs, some types are resistant to medication.The present study,aims to investigate the effect of methylprednisolone treatment on seizure frequency in patients with drug resistant focal impaired awareness seizures.
Materials and Methods
This study involved 20 patients with focal impaired awareness seizures who had used multiple antiseizure drugs but had not experienced a seizure-free period longer than six months. The clinical and demographic characteristics of the patients were assessed. Each patient received a single course of intravenous (IV) pulse methylprednisolone therapy for 5 consecutive days. Patients were followed up for three months before and after the treatment. Seizure frequencies and electroencephalogram (EEG) findings,during the three months pre-treatment and post-treatment periods were compared. Patients experiencing a decrease in seizure frequency of more than 50% three months after treatment, in comparison to the pre-treatment period,were considered responders to the therapy.
Results
As a result of the study,4 patients responded positively to the treatment.One of these 4 patients became completely seizure-free.However,no statistically significant difference was found between pre-treatment and post-treatment seizure frequencies.Among nine patients with epileptiform findings on their pre-treatment EEG, these findings disappeared in four patients post-treatment.Nevertheless, the differences in EEG findings before and after treatment were also not statistically significant.
Conclusion
In our study, a single course of IV methylprednisolone therapy in patients with focal impaired awareness seizures did not yield a significant therapeutic response.It has been surmised that,a more efficient response to treatment would be achieved in case of continuing corticosteroid therapy with repeated doses in patients with treatment refractory focal impaired awareness seizures.
Ethical Statement
Ethics Committee Approval: The study was approved by Ministry of Health Ankara Diskapi Yildirim Beyazit Training and Research Ethics Committees (approval number: 28/22, date:04.04.2016)
References
- Poonam Nina B.,David F,W Allen H. The descriptive epidemiology of epilepsy-a review Epilepsy Res.2009; 85(1): 31–45. https://doi.org/10.1016/j.eplepsyres.2009.03.003
- Kwan P, Arzimanoglou A, Berg AT, et al. Definition of drug resistant epilepsy: consensus proposal by the ad hoc task force of the ILAE commission on therapeutic strategies. Epilepsia. 2010;51(6):1069‐1077. doi: 10.1111/j.1528-1167.2009.02397.
- Mohanraj R, Brodie MJ. Outcomes of newly diagnosed idiopathicgeneralized epilepsy syndromes in a non-pediatric setting. Acta NeurolScand. 2007;115(3):204–208. doi: 10.1111/j.1600-0404.2006.00791
- Szaflarski JP, Lindsell CJ, Zakaria T, Banks C, Privitera MD. Seizure control in patients with idiopathic generalized epilepsies:EEG determinants of medication response. Epilepsy Behavior.2010;17(4):525–530. doi:10.1016/j.yebeh.2010.02.005
- Mohanraj R., Brodie M.J.: Early predictors of outcome in newly diagnosed epilepsy. Seizure 2013; 22: pp. 333-344. doi: 10.1016/j.seizure.2013.02.002.
- Heida JG, Pittman QJ. Causal links between brain cytokines and experimental febrile convulsions in the rat. Epilepsia. (2005) 46:1906– 13. doi: 10.1111/j.1528-1167.2005.00294
- Van Vliet EA, Aronica E, Vezzani A, Ravizza T. Review: neuroinflammatory pathways as treatment targets and biomarker candidates in epilepsy: emerging evidence from preclinical and clinical studies. Neuropathol Appl Neurobiol. 2018; 44:91–111 doi: 10.1111/nan.12444.
- Orsini A, Foiadelli T, Costagliola G, Michev A, Consolini R, Vinci F, et al. The role of inflammatory mediators in epilepsy: focus on developmental and epileptic encephalopathies and therapeutic implications. Epilepsy Res. 2021; 172:106588. doi: 10.1016/j.eplepsyres.2021.106588.
- Nylander A., Hafler D.A. Multiple sclerosis. J. Clin. Invest. 2012;122 doi: 10.1172/JCI58649
- Ong M.-S., Kohane I.S., Cai T., Gorman M.P., Mandl K.D. Population-Level Evidence for an Autoimmune Etiology of Epilepsy. JAMA Neurol. 2014; 71:569–574.
- Meng F., Yao L. The role of inflammation in epileptogenesis. Acta Epileptol. 2020; 2:15.
- Aykut-Bingol C, Arman A, Tokol O, et al. Pulse methylprednisolone therapy in Landau-Kleffner syndrome. 1996; J Epilepsy 9:189-191.
- Tsuru T, Mori M, Mizuguchi M, et al. Effects of high-dose intravenous corticosteroid therapy in Landau-Kleffner syndrome. 2000; Pediatr Neurol 22:145-147. doi: 10.1016/s0887-8994(99)00127-7.
- Okuyaz C, Aydin K, Gücüyener K, et al. Treatment of electrical status epilepticus during slow-wave sleep with high-dose corticosteroid. 2005; Pediatr Neurol 32:64-67. doi: 10.1016/j
- Sevilla-Castillo RA, Palacios GC, Ramirez-Campos J, et al. Methylprednisolone for the treatment of children with refractory epilepsy. 2009; Neuropediatrics 40:265-268. doi:10.1055/s-0030-1249653
- Lichtenfeld R, Heyman E, Gandelman-Marton R, et al. Intravenous methylprednisolone pulse therapy in a young girl with intractable absence seizures. 2010. Isr Med Assoc J 12:181-182
- Mytinger JR, Quigg M, Taft WC, et al (2010). Outcomes in treatment of infantile spasms with pulse methylprednisolone. J Child Neurol 25:948-95. doi:10.1177/08830 73809356107.
- Heyman E, Lahat E, Gandelman-Marton R . Interictal encephalography can influence patient selection for methylprednisolone therapy in pediatric refractory epilepsy. 2012; J Child Neurol 27:162-167. doi:10.1177/0883073811414905
- Almaabdi KH, Alshehri RO, Althubiti AA, et al. Intravenous methylprednisolone for intractable childhood epilepsy. Pediatr Neurol. 2014; 50:334-336. doi: 10.1016/j.
- Marchi N, Granata T, Freri E, et al. Efficacy of anti-inflammatoryütherapy in a model of acute seizures and in a populationof pediatric drug resistant epileptics. PLoS One. 2011; 28;6(3):e18200. 6:e18200.doi: 10.1371/journal.pone.0018200.
- Vezzani A, Granata T. Brain inflammation in epilepsy:experimental and clinical evidence. Epilepsia. 2005; 46:1724-1743. doi: 10.1111/j.1528-1167.2005.00298
- Özkara Ç, Vigevano F. Immuno- and antiinflammatory therapies in epileptic disorders. Epilepsia. 2011; 3:45-51. doi:10.1111/j.1528-1167.2011.03036
- Bien CG, Urbach H, Schramm J, et al. Limbic encephalitis as a precipitating event in adult-onset temporal lobe epilepsy. Neurology 2007; 69:1236–1244. doi: 10.1212/01.wnl.0000276946.08412.ef.
- Maria Carmela Pera,Giovanna Randazzo,Silvia Masnada,et al. Intravenous methylprednisolone pulse therapy for children with epileptic encephalopathy. Functional Neurology 2015; 30(3): 173-179. doi:10.11138/fneur/2015.30.3.173
Details
| Primary Language | English |
|---|---|
| Subjects | Neurology and Neuromuscular Diseases |
| Journal Section | Original Research Paper |
| Authors | |
| Publication Date | April 30, 2025 |
| Submission Date | March 7, 2025 |
| Acceptance Date | March 25, 2025 |
| Published in Issue | Year 2025 Volume: 17 Issue: 1 |
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