HIGH-DOSE IMMUNOGLOBULIN THERAPY OF EPILEPSY IN CHILDREN

High-dose, intravenously administered immunoglobulins have been successfully applied to a few cases of childhood epilepsy and led to a reduction of the seizure frequency in a number of studies. In the present study 4 patients with myoclonic-astatic petit mal or myoclonic absence were treated with intravenously administered immunoglobulins (400 mg/kg for 5 days). Deterioration occurred in 1 patient, 1 patient showed no effect, and 2 patients showed a partial and transient response. Theoretically, the rationale for immunoglobulin therapy in epilepsy is based on the assumption of autoimmune mechanisms as being the underlying pathogenesis. However, a review of the literature showed that the few studies available differ in the form of epilepsy treated and the effects obtained. No study correlated the effects of immunoglobulin administration with a presumptive autoimmune disorder. As a result, high-dose intravenous immunoglobulin treatment of childhood epilepsy remains empirical and the group of patients who might benefit from such a treatment continues to be poorly defined.