[Intravenous treatment with immunoglobulins in epileptic syndromes which are difficult to control]

Several mechanisms have been found to be involved in the development of malignant epileptic syndromes in childhood and an immunological component has been shown in experimental studies of epilepsy. The effect of intravenous immunoglobulin (IgIV) has been reported in various cases of epilepsy which were difficult to control.

To show the usefulness of IgIV in West s syndrome (WS) and Lennox Gastaut syndrome (LGS) which were difficult to control.

We selected five patients who fulfilled the criteria for WS and LGS which were difficult to control. They were given IgIV for five days and subsequently six fortnightly doses of 0.5 g/kg/day. We recorded data on sex, age, onset of the disorder and laboratory investigations, including blood and cerebrospinal fluid (CSF) immunoglobulin levels.

Four girls with symptomatic WS and one boy with LGS as a symptom of a neuro infection. Treatment was started at the age of 8 14 months. The spasms varied between 204 and 1,074 in 24 hours, and were markedly reduced after IgIV was given. The IgG in the CSF rose as the number of spasms fell (p< 0.05).

There was a satisfactory response to treatment, as reported in previous publications. It is a coadjuvant treatment for cases which are difficult to control and may also be useful in cases of symptomatic epilepsy where goods results are also obtained.