TREATMENT OF SEVERE MYOCLONIC EPILEPSY IN INFANTS WITH BROMIDE AND ITS BORDERLINE VARIANT

We studied the efficacy of bromides (BR) as add-on therapy in 11 patie nts with severe myoclonic epilepsy in infants (SME) and in another 11 with the borderline variant of SME (BVSME). Study subjects were aged 8 .5-183 months (mean 64.4 months). Longest duration of BR treatment was 37 months (range 4-37 months; mean 19.7 months). Eight of 22 (36%) of patients with generalized tonic-clonic seizures (GTCS) had an excelle nt effect (>75% reduction in total seizure frequency or duration) and 9 (41%) had a moderate effect (50-75% reduction) 3 months after introd uction of BR. Twelve months after initiation of BR, 5 of the patients with significant improvement were no longer responsive; ultimately, th erefore, 6 had an excellent effect and 2 had a moderate effect. Of tho se with partial seizures (n = 5) and myoclonic/absence seizures (n = 5 ), only 1 patient in each group showed a moderate effect at the 12-mon th time-point. Dosages and serum concentrations of BR ranged from 30 t o 100 mg/kg (mean 58 mg/kg) and from 64 to 159 mg/dl (mean 101 mg/dl), respectively. Of the 12 patients experiencing side effects, including drowsiness, appetite loss, and skin rash, 1 required a reduction in B R dosage because of an extensive acneiform rash on the face. The resul ts show that BR treatment holds promise for patients with SME and BVSM E and should therefore be investigated further.