Version 1
: Received: 7 March 2024 / Approved: 8 March 2024 / Online: 8 March 2024 (10:02:56 CET)
Version 2
: Received: 9 March 2024 / Approved: 11 March 2024 / Online: 11 March 2024 (13:15:43 CET)
Russo, A.; Mazzone, S.; Landolina, L.; Colucci, R.; Baccari, F.; Fetta, A.; Boni, A.; Cordelli, D.M. Efficacy and Safety of Pulse Intravenous Methylprednisolone in Pediatric Epileptic Encephalopathies: Timing and Networks Consideration. J. Clin. Med.2024, 13, 2497.
Russo, A.; Mazzone, S.; Landolina, L.; Colucci, R.; Baccari, F.; Fetta, A.; Boni, A.; Cordelli, D.M. Efficacy and Safety of Pulse Intravenous Methylprednisolone in Pediatric Epileptic Encephalopathies: Timing and Networks Consideration. J. Clin. Med. 2024, 13, 2497.
Russo, A.; Mazzone, S.; Landolina, L.; Colucci, R.; Baccari, F.; Fetta, A.; Boni, A.; Cordelli, D.M. Efficacy and Safety of Pulse Intravenous Methylprednisolone in Pediatric Epileptic Encephalopathies: Timing and Networks Consideration. J. Clin. Med.2024, 13, 2497.
Russo, A.; Mazzone, S.; Landolina, L.; Colucci, R.; Baccari, F.; Fetta, A.; Boni, A.; Cordelli, D.M. Efficacy and Safety of Pulse Intravenous Methylprednisolone in Pediatric Epileptic Encephalopathies: Timing and Networks Consideration. J. Clin. Med. 2024, 13, 2497.
Abstract
Background: epileptic encephalopathies (EE) are characterized by severe drug-resistant seizures, early-onset, and unfavorable developmental outcome.
We describe a cohort of pediatric patients with EE who underwent intravenous methylprednisolone (IVMP) pulse therapy to examine its efficacy/tolerability.
Methods: This is a retrospective study from 2020 to 2023. Inclusion criteria were: ≤18 years at the time of IVMP pulse therapy and at least 6 months of follow-up. Efficacy and outcome, defined as seizure reduction >50% (responder rate), were evaluated at 6 and 9 months of therapy, and 6 months after therapy suspension; quality of Life (QoL) was also assessed.
Variables predicting positive post-IVMP outcomes were identified using statistical analysis.
Results: Twenty-one patients were included. The responding rate was 85.7% at 6 and 9 months of therapy, and 80.9% at 6 months after therapy suspension.
Variables significantly predicting favorable outcome were etiology (p =0,0475) and epilepsy type (p =0,0475), with the best outcome achieved in patients with genetic epilepsy and those with encephalopathy related to electrical status epilepticus during slow-wave sleep (ESES). All patients evidenced improved QoL at the last follow-up. No relevant adverse events were observed.
Conclusions: Our study confirms the efficacy and high tolerability of IVMP pulse therapy in patients with EE. Genetic epilepsy and ESES were positive predictor of favorable clinical outcome. QOL, EEG features and posture-motor development showed an improving trend as well. IVMP pulse therapy should be considered earlier in patients with EE.
Medicine and Pharmacology, Neuroscience and Neurology
Copyright:
This is an open access article distributed under the Creative Commons Attribution License which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
