Evaluation of the effectiveness of anticonvulsant and hormonal therapy for epileptic spasms in the group of Russian patients

Introduction. Epileptic spasms (ES) are a special type of epileptic seizures, accompanied by hypsarrhythmia on the interictal electroencephalogram (EEG) and regression of psychomotor development. ES are the most common cause of epileptic encephalopathy in infancy.

Materials and methods. We examined two hundred three  children with the age of onset of epileptic spasms up to 2 years.  The patient were selected in retrospective group including  180 children (boys — 95/180 (52.7%), girls — 85/180 (47.3%)) (χ²=0.9, p=0.3428) and  prospective group consisted of  23 children (boys — 13/23 (56.5%), girls — 10/23 (43.5%) (χ² = 0.3478, p = 0.5553.

Results. The present study demonstrates the need for sleep electroencephalogram in children with developmental delay or regression. Our work confirms  in general, antiepileptic drugs, with the exception of vigabatrin in children with tuberous sclerosis-associated epilepsy, to show low efficacy in the group of children without tuberous sclerosis as seizures were stopped in 14.3% of cases. The use of methylprednisolone (the regimen includes pulse therapy followed by prolonged oral administration of the drug) makes it possible to achieve the cessation of seizures and the disappearance of hypsarrhythmia in 69.5% of patients. Methylprednisolone is a fairly safe and well tolerated hormone. The study did not record any life-threatening side effects among the prospective and retrospective groups.The treatment regimen using methylprednisolone shows equal efficacy with the regimen using tetracosactide. 

Conclusion. The results of the study demonstrate the need for early corticosteroid therapy in ES children. 

Contribution:
Okhapkina T.G. — concept, writing text;
Belousova E.D. — concept, writing text;
Kalmykova G.V. — text editing.
All co-authors are responsible for the integrity of all parts of the manuscript and approval of its final version.

Acknowledgements. The study had no sponsorship.

Conflict of interest. The authors declare no conflict of interest.

Received: November 5, 2022
Accepted:  December 5, 2022
Published: January 15, 2023

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