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Published on: May 16, 2019
Intravenous immunoglobulin G as adjuvant treatment in drug-resistant childhood epilepsy
Z González-Castillo1, E Solórzano Gómez1, A Torres-Gómez2
1Departamento de Neurología Pediátrica, Centro Médico Nacional 20 de Noviembre, ISSSTE, Ciudad de México, México.
Insights
Intravenous immunoglobulin G (iIV IgG) shows promise in reducing seizure frequency and duration for pediatric patients with drug-resistant epilepsy. This adjuvant therapy offers a potential new treatment avenue for difficult-to-manage childhood epilepsy cases.
Area of Science:
- Neurology
- Pediatrics
- Immunology
Background:
- Epilepsy is a common childhood neurological disorder, with drug-resistant epilepsy affecting 10-23% of pediatric patients.
- Identifying effective treatments for drug-resistant epilepsy in children is a significant clinical challenge.
Purpose of the Study:
- To evaluate the efficacy of adding intravenous immunoglobulin G (iIV IgG) as an adjuvant therapy.
- To assess the impact of iIV IgG on seizure frequency and duration in pediatric patients with drug-resistant epilepsy.
Main Methods:
- An analytic, observational, retrospective case-control study was conducted.
- Paediatric patients with drug-resistant epilepsy treated with iIV IgG between 2003 and 2013 were analyzed.
- Seizure frequency and duration were compared before and after the initiation of iIV IgG treatment.
Main Results:
- Out of 167 patients with drug-resistant epilepsy, 44 received adjuvant iIV IgG therapy.
- A significant reduction in seizure duration (66.66%) was observed at 2 months post-treatment.
- Seizure frequency decreased by 64% at 4 months after initiating iIV IgG (P<.001).
Conclusions:
- Intravenous immunoglobulin G (iIV IgG) demonstrates potential as an effective adjunctive therapy.
- iIV IgG may significantly reduce seizure frequency and duration in pediatric drug-resistant epilepsy.
- This finding suggests a new therapeutic option for managing refractory childhood epilepsy.
Background:
Epilepsy is the most common neurological disease in childhood; depending on the definition of drug-resistant epilepsy, incidence varies from 10% to 23% in the paediatric population. The objective of this study was to account for the decrease in the frequency and/or monthly duration of epileptic seizures in paediatric patients with drug-resistant epilepsy treated with antiepileptic drugs, before and after adding intravenous immunoglobulin G (iIV IgG).
Methods:
This is an analytic, observational, retrospective case-control study. We studied paediatric patients with drug-resistant epilepsy who were treated with IV IgG at the Centro Médico Nacional 20 de Noviembre, in Mexico City, from 2003 to 2013.
Results:
One hundred and sixty seven patients (19.5%) had drug-resistant epilepsy and 44 (5.1%) started adjuvant treatment with IV IgG. The mean age of patients at the beginning of treatment was 6.12 years±5.14); aetiology was structural acquired in 28 patients (73.6%), genetic in 5 (13.1%), immune in 1 (2.6%), and unknown in 4 (10.5%). At 2 months from starting IV IgG, seizure duration had reduced to 66.66%; the frequency of seizures was reduced by 64% at 4 months after starting treatment (P<.001).
Conclusions:
According to the results of this study, intravenous immunoglobulin may be an effective therapy for reducing the frequency and duration of seizures in paediatric patients with drug-resistant epilepsy.
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