Effectiveness of high-dose intravenous dexamethasone as adjunctive therapy in difficult-to-control pediatric epilepsy

Abstract

Introduction: epilepsy is one of the most prevalent chronic neurological conditions. Objective: to describe the effectiveness of treatment with high-dose intravenous dexamethasone, added to anti-seizure medications, in patients with difficult-to-control epilepsy treated in the Neuropediatrics Department of the “Juan Manuel Márquez Children's Hospital, La Habana, Cuba, from January 2018 to November 2024.

Methods: a descriptive case series study was conducted, based on a compilation of all epileptic patients discharged from the Pediatric Neurology Department. Medical records were analyzed, and those treated with high doses of dexamethasone were selected. The distribution of patients by age at beginning of treatment and the minimum and maximum values ​​of the total were estimated. The qualitative variables were summarized as absolute frequencies and percentages.

Results: eight cases were studied, which corresponded to a low proportion of patients treated with dexamethasone among the total discharged patients. The predominant age at first treatment was 3 years, and patients with more than one type of seizure and those diagnosed with Lennox-Gastaut Syndrome were the most prevalent. The cause of the epilepsy was unknown in half of the cases. At the end of the first set of cycles, seven patients attained ≥ 50 % decrease in seizure frequency, no adverse reactions to treatment occurred, and three required more than one set of treatment cycles.

Conclusions: dexamethasone was prescribed in a low proportion of cases; however, it was highly effective or effective in the majority of patients (7/8: 87.5 %), with Lennox-Gastaut syndrome being the most common.