A prospective study of dexamethasone therapy in refractory epileptic encephalopathy with continuous spike-and-wave during sleep
| Autor: | Li Jiang, Jin Chen, Yue Hu, Chenggong Feng, Fang-cheng Cai |
|---|---|
| Rok vydání: | 2015 |
| Předmět: |
0301 basic medicine
Male Drug Resistant Epilepsy Intelligence Anti-Inflammatory Agents Dexamethasone 03 medical and health sciences Behavioral Neuroscience Epilepsy 0302 clinical medicine Recurrence medicine Outpatient clinic Humans Prospective Studies Prospective cohort study Child Brain Diseases business.industry Electroencephalography medicine.disease Discontinuation 030104 developmental biology Treatment Outcome Neurology Tolerability Anesthesia Child Preschool Prednisolone Disease Progression Female Neurology (clinical) business 030217 neurology & neurosurgery medicine.drug Follow-Up Studies |
| Zdroj: | Epilepsybehavior : EB. 55 |
| ISSN: | 1525-5069 |
| Popis: | Purpose Epileptic encephalopathy with continuous spike-and-wave during sleep (CSWS) is an intractable form of epilepsy that has no consensus protocol for corticosteroid therapy. This prospective study aimed to evaluate the efficacy and tolerability of dexamethasone for the treatment of CSWS. Methods Patients (age: 4 years to 12 years and 5 months) with CSWS that failed to respond to several antiepileptic drugs and prednisolone at our pediatric neurology outpatient clinic between 2007 and 2015 were treated with dexamethasone and prospectively analyzed. An initial 4-week dexamethasone (0.15 mg/kg/day p.o.) scheme was employed, and response was assessed. If effective, dexamethasone was maintained for 2–3 months and then slowly weaned over several months, depending on individual patient response at each follow-up. Systemic evaluations (clinical evaluations, electroencephalography recordings, and analysis of side effects) were performed regularly thereafter. Results Among 15 patients, 7 were defined as initial responders after 4-week dexamethasone treatment based on comprehensive clinical and electroencephalogram evaluations. The duration of dexamethasone treatment (including weaning) in these 7 patients was 6 to 10 months, and the follow-up duration was 6 months to 7 years. Three patients had no relapse after dexamethasone withdrawal at last follow-up. Among the other 4 patients, relapse was observed during dexamethasone withdrawal (n = 1) or at 2–6 months after discontinuation of dexamethasone therapy (n = 3). There were no serious or life-threatening side effects, and all observed side effects were reversible after discontinuation of dexamethasone. Conclusions Continuous oral dexamethasone treatment is an effective and tolerable therapy and should be an option for the treatment of CSWS. |
| Databáze: | OpenAIRE |
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