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Updated: Aug 20, 2025

Author Spotlight: Advancing Pediatric Epilepsy Surgery in Children Through Novel Biomarkers and Enhanced Localization
Published on: September 20, 2024
CORTICOSTEROIDS IN THE MANAGEMENT OF PEDIATRIC EPILEPSIES
Igor Prpić1, Ines Blažeković1, Jelena Radić Nišević1
11Rijeka University Hospital Centre, Department of Pediatrics, Division of Child Neurology and Child Psychiatry, Referral Centre for Childhood Epilepsies and Convulsive Disorders, Rijeka, Croatia; 2Faculty of Medicine, University of Rijeka, Rijeka, Croatia; 3Faculty of Health Studies, University of Rijeka, Rijeka, Croatia.
Insights
Corticosteroid therapy (CT) is an alternative for drug-resistant childhood epilepsy. This study analyzed CT types in 32 children, finding combined prednisone and methylprednisolone most common, highlighting the need for universal treatment guidelines.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
Background:
- Epilepsy affects many children, with 30% resistant to conventional antiepileptic drugs.
- Corticosteroid therapy (CT) serves as an alternative treatment for drug-resistant childhood epilepsy.
Purpose of the Study:
- To analyze different types of corticosteroid therapy (CT) used for drug-resistant childhood epilepsies.
- To evaluate CT usage patterns at Rijeka University Hospital Centre between 2016-2020.
Main Methods:
- Retrospective study of 32 pediatric patients with drug-resistant epilepsy.
- Analysis of patient demographics, epilepsy characteristics, comorbidities, MRI findings, and CT regimens.
Main Results:
- Average age at epilepsy onset was 14 months; average epilepsy duration before CT was 16 months.
- 53.13% had MRI changes, 81.25% had comorbidities; average of 5 antiepileptic drugs were used prior to CT.
- Prednisone was used in 28.13%, combined prednisone/methylprednisolone in 65.63%, and methylprednisolone in 6.25% of patients.
Conclusions:
- Corticosteroid therapy (CT) is a crucial option for refractory childhood epilepsy.
- Significant variation exists in CT application, underscoring the need for standardized treatment guidelines.
Abstract:
Epilepsy is one of the most common chronic diseases in children, and cannot be controlled with conventional antiepileptic drugs in 30% of cases. Therefore, in these cases, alternative approach such as corticosteroid therapy (CT) is used. The aim of this study was to analyze different types of CT used to treat drug-resistant childhood epilepsies, treated at Rijeka University Hospital Centre during a 5-year period (2016-2020). This retrospective study included 32 patients. The following parameters were analyzed: number of patients with a particular diagnosis, average age (in months) at the onset of epilepsy, average epilepsy duration (in months) prior to CT, average number of antiepileptic drugs used prior to CT, presence of changes on magnetic resonance imaging (MRI), presence of comorbidities, and types of CT. The average age at the onset of epilepsy was 14 months and average epilepsy duration prior to CT was 16 months. On average, 5 antiepileptic drugs were used prior to CT. MRI changes were present in 53.13% and comorbidities in 81.25% of study patients. Prednisone therapy was used in 28.13%, combined therapy with prednisone and methylprednisolone in 65.63%, and methylprednisolone in 6.25% of patients. Study results revealed the use of CT for particular diagnosis to differ among the centers, as well as within the same center, so it is important to highlight the importance of reaching universal guidelines for CT therapy of childhood epilepsies.
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