Abstract：
OBJECTIVE: Our study aimed to evaluate the effectiveness of corticosteroids on seizure control in drug-resistant epilepsies (DREs). Our primary goal was to assess the response to steroids for various underlying etiologies, interictal electroencephalographic (EEG) patterns and electroclinical seizure descriptions. Our second goal was to compare steroid responsiveness to different treatment protocols.
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).
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).
摘要：
目的：我们的研究旨在评估皮质类固醇对耐药癫痫（DREs）癫痫发作控制的有效性。我们的主要目标是评估各种潜在病因对类固醇的反应，发作间脑电图（EEG）模式和电临床癫痫发作描述。我们的第二个目标是比较类固醇对不同治疗方案的反应性。
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。
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。
