Patients with a specific intractable form of epilepsy could benefit from treatment with the steroid therapy dexamethasone.This is according to a new study from Chongqing Medical University in China, published in the medical journal Epilepsy & Behavior, which aimed to evaluate the efficacy and tolerability of dexamethasone for the treatment of epileptic encephalopathy with continuous spike-and-wave during sleep (CSWS).Characterised by nocturnal seizures, CSWS accounts for between 0.2 per cent and 0.5 per cent of all childhood epilepsy cases. Currently, there is no consensus on the best corticosteroid therapy approach for treating the disease.A total of 15 patients between the ages of four and 12 with CSWS who had failed to respond to several antiepileptic drugs and prednisolone at a paediatric neurology outpatient clinic between 2007 and 2015 were treated with dexamethasone and prospectively analysed.The initial four-week dexamethasone regimen was followed by an assessment. If effective, dexamethasone was maintained for two to three months, and then slowly weaned over several months, depending on the response of the individual patient at each follow-up.It was shown that seven were defined as initial responders after the initial four-week treatment, based on comprehensive clinical and electroencephalogram evaluations. The duration of dexamethasone treatment – including weaning – in these seven patients was six to ten months, while the follow-up duration was six months to seven years.Three patients had no relapse after dexamethasone withdrawal at the last follow-up. Among the other four patients, relapse was observed during dexamethasone withdrawal or at two to six months after discontinuation of the treatment.No serious or life-threatening side effects were recorded, with all observed side effects shown to be reversible after the discontinuation of dexamethasone.The researchers concluded: “Continuous oral dexamethasone treatment is an effective and tolerable therapy and should be an option for the treatment of CSWS.”Posted by Anne BrownClick here for more articles about anti-epileptic drugs and pregnancy risks.