The Use of Intravenous Immunoglobulins and Prednisone in the Treatment of Intractable Pediatric Epilepsy

Abstract

Intractable epilepsy afflicts approximately 25% of children with epilepsy.  Because antiepileptic medications (AEDs) share similar mechanisms of action aimed at affecting neuronal ion channels or neurotransmitter receptors, it is not surprising that the likelihood of additional AEDs resulting in significant seizure reduction is low with risks outweighing potential benefit. In addition, it is unclear if AEDs can modify the underlying process promoting seizures.  Intravenous immunoglobulins (IVIg) and prednisone have been used as alternative therapies in children with intractable epilepsy after multiple AEDs have been tried unsuccessfully.  Recent evidence has suggested that neuroinflammation may play a role in epileptogenesis giving credence to the use immune modulatory agents in refractory epilepsy.  In this research highlight, we will discuss our recent study examining and comparing the use of IVIg and prednisone in treating intractable pediatric epilepsy.