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.

Acta Clinica Croatica
|November 21, 2022
PubMed

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.

Related Concept Videos

Antiepileptic Drugs: Glutamate Antagonists01:14

Antiepileptic Drugs: Glutamate Antagonists

Glutamate is a fundamental neurotransmitter in the central nervous system, playing a vital role in neuronal communication and various cognitive processes. Glutamate stands as the principal excitatory neurotransmitter in the brain. Its presence is crucial for the communication between neurons, underpinning essential processes such as synaptic transmission, neuronal excitability, and plasticity. These functions are vital for higher-order cognitive processes, including learning and memory. The...
475
Epilepsy and Seizures: Overview01:24

Epilepsy and Seizures: Overview

Epilepsy is a chronic neurological disease marked by recurrent, unpredictable seizures. These seizures are caused by abnormal electrical discharges in the brain, leading to behavior, sensation, or consciousness alterations. They can also cause transient impairment of awareness, interfering with daily activities.
Various factors can trigger epilepsy, including genetic factors, brain damage, metabolic causes, and unknown etiology. Diagnosis of epilepsy involves electroencephalography (EEG), which...
242
Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids01:25

Antiasthma Drugs: Inhaled Corticosteroids and Glucocorticoids

Inhaled corticosteroids (ICS) are anti-inflammatory drugs used primarily in treating persistent asthma and providing long-term maintenance. They target the bronchial mucosa, the lining of the airways, to control inflammation, a critical factor in asthma progression and exacerbation.
ICS work through a multifaceted mechanism of action. They suppress the inflammatory response caused by the proliferation of TH cells. They also reduce the transcription of the IL-2 gene, which is involved in the...
354
Antiepileptic Drugs: GABAergic Pathway Potentiators01:18

Antiepileptic Drugs: GABAergic Pathway Potentiators

γ-aminobutyric acid or GABA, plays a pivotal role as an inhibitory neurotransmitter in the brain. GABA pathway potentiators, also known as GABAergic drugs, are a class of pharmaceutical agents designed to enhance the functioning of the GABAergic system. These medications primarily treat epilepsy, a neurological disorder characterized by recurrent seizures.
The key GABA pathway potentiators used in epilepsy management are as follows.
Benzodiazepines are a well-known class of drugs used for...
521
Antiepileptic Drugs: Sodium Channel Blockers01:08

Antiepileptic Drugs: Sodium Channel Blockers

Antiepileptic drugs are specialized medications that prevent seizures in individuals diagnosed with epilepsy. These drugs primarily function by blocking the movement of sodium ions through channels in the neuronal membrane, inhibiting the repetitive firing of action potentials often associated with seizures.
Sodium channel blockers modulate ion channels, particularly voltage-gated sodium channels. They block only sodium ion movement.
Among the most commonly prescribed antiepileptic drugs are...
795
Antiepileptic Drugs: Calcium Channel Blockers01:17

Antiepileptic Drugs: Calcium Channel Blockers

Calcium channel blockers, a class of antiepileptic drugs, regulate the flow of calcium ions within neurons.
Calcium channel blockers exert their antiepileptic effects by targeting T-type calcium channels, which are integral to transmitting nerve signals in the central nervous system. These channels allow the passage of calcium ions, which are vital for neuronal communication. By inhibiting T-type calcium channels, calcium channel blockers effectively reduce the release of neurotransmitters and...
539