The Effect Of Immunotherapy on Seizure Frequency in Drug Resistant Focal Seizures

Objective: Epilepsy is an important neurological disorder with serious consequences for both patients and society. Even though most cases of epilepsy can be controlled with antiseizure drugs, some types are resistant to medication.The present study,aims to investigate the effect of methylprednisolone treatment on seizure frequency in patients with drug resistant focal impaired awareness seizures. Materials and Methods This study involved 20 patients with focal impaired awareness seizures who had used multiple antiseizure drugs but had not experienced a seizure-free period longer than six months. The clinical and demographic characteristics of the patients were assessed. Each patient received a single course of intravenous (IV) pulse methylprednisolone therapy for 5 consecutive days. Patients were followed up for three months before and after the treatment. Seizure frequencies and electroencephalogram (EEG) findings,during the three months pre-treatment and post-treatment periods were compared. Patients experiencing a decrease in seizure frequency of more than 50% three months after treatment, in comparison to the pre-treatment period,were considered responders to the therapy. Results As a result of the study,4 patients responded positively to the treatment.One of these 4 patients became completely seizure-free.However,no statistically significant difference was found between pre-treatment and post-treatment seizure frequencies.Among nine patients with epileptiform findings on their pre-treatment EEG, these findings disappeared in four patients post-treatment.Nevertheless, the differences in EEG findings before and after treatment were also not statistically significant. Conclusion In our study, a single course of IV methylprednisolone therapy in patients with focal impaired awareness seizures did not yield a significant therapeutic response.It has been surmised that,a more efficient response to treatment would be achieved in case of continuing corticosteroid therapy with repeated doses in patients with treatment refractory focal impaired awareness seizures.