Corticosteroids in childhood epilepsies: A systematic review

Area of Science:

• Neurology
• Pediatric Neurology
• Clinical Pharmacology

Background:

• Corticosteroids have been utilized for epilepsy treatment for over 60 years.
• The underlying hypothesis involves inflammation in epilepsy's development and progression.
• A systematic review is needed to evaluate corticosteroid efficacy in childhood epilepsies.

Purpose of the Study:

• To systematically review the application of corticosteroid regimens in childhood epilepsies.
• To assess the evidence supporting steroid use in various pediatric epilepsy syndromes.
• To identify gaps in research and guide future clinical studies.

Main Methods:

• A structured literature search was conducted via PubMed.
• 160 papers were identified, with a focus on randomized controlled trials.
• Studies on epileptic spasms were considered separately due to substantial existing data.

Main Results:

• Evidence strongly supports steroid use for epileptic spasms.
• Limited evidence shows positive effects in (D)EE-SWAS (64% improvement) and drug-resistant epilepsies (DRE) (50% seizure reduction).
• High variability in corticosteroid regimens, dosages, and treatment durations was observed across studies.

Conclusions:

• Corticosteroids are effective for epileptic spasms.
• Further controlled studies are essential for (D)EE-SWAS and especially for drug-resistant epilepsies.
• Steroid therapy may offer new treatment avenues for pediatric epilepsy patients, particularly those with refractory cases.