METHODS: This is a retrospective multicentre cohort study conducted according to the STROBE guidelines (Strengthening the Reporting of Observational Studies in Epidemiology). The following data were collected for each patient: epilepsy etiology, interictal EEG pattern, seizure types and type of steroid treatment protocol administered.
RESULTS: Thirty patients with DRE were included in the study. After 6 months of therapy, 62.7 % of patients experienced reduced seizure frequency by 50 %, and 6.6 % of patients experienced complete seizure cessation. Findings associated with favourable response to steroids included structural/lesional etiology of epilepsy, immune/infectious etiology and focal interictal abnormalities on EEG. Comparing four different steroid treatment protocols, the most effective for seizure control was treatment with methylprednisolone at the dose of 30 mg/kg/day administered for 3 days, leading to greater than 50 % seizure reduction at 6 months in 85.7 % of patients. Treatment with dexamethasone 6 mg/day for 5 days decreased seizure frequency in 71.4 % of patients. Hydrocortisone 10 mg/kg administered for 3 months showed a good response to treatment in 71 %.
CONCLUSIONS: In our study, two-thirds of patients with DRE experienced a significant seizure reduction following treatment with steroids. We suggest considering steroids as a potential therapeutic option in children with epilepsy not responding to conventional antiseizure medicines (ASM).
方法:这是一项根据STROBE指南(加强流行病学观察性研究报告)进行的回顾性多中心队列研究。收集每位患者的以下数据:癫痫病因,发作间脑电图模式,癫痫发作类型和类固醇治疗方案的类型。
结果:30例DRE患者纳入研究。经过6个月的治疗,62.7%的患者癫痫发作频率减少了50%,和6.6%的患者经历了完全停止癫痫发作。与类固醇反应良好相关的发现包括癫痫的结构/病变病因,免疫/感染病因和脑电图局灶性发作间异常。比较四种不同的类固醇治疗方案,控制癫痫发作最有效的是甲基强的松龙以30mg/kg/天的剂量治疗3天,导致85.7%的患者在6个月时癫痫发作减少超过50%。用地塞米松6mg/天治疗5天,71.4%的患者癫痫发作频率降低。10mg/kg氢化可的松给药3个月显示出对治疗的良好反应,占71%。
结论:在我们的研究中,三分之二的DRE患者在接受类固醇治疗后癫痫发作明显减少.我们建议将类固醇作为对常规抗癫痫药物(ASM)无反应的癫痫儿童的潜在治疗选择。