THE POTENTIAL OF IMMUNOGLOBULIN THERAPY IN INTRACTABLE SEIZURES

Immunological mechanisms have been implicated in the pathogenesis of e pileptic seizures in experimental animal models of epilepsy and in som e patients with epilepsy. In the wake of these observations, clinical trials with high dose intravenous gamma immunoglobulin (IVIg) have sho wn this drug to be effective and well tolerated in some children with intractable seizures. The overall results with IVIg are encouraging - complete remission occurs in 25% of patients and mild to moderate resp onse is observed in 30%. Particularly favourable results are obtained in patients with a short duration of seizure disorder and relatively p reserved cognitive function prior to therapy. The full potential of IV Ig in intractable epilepsy will only be defined following a better und erstanding of the intricacies of the mechanisms involved in epileptic syndromes and IVIg therapy. Long term controlled studies designed to i dentify predictors of response, optimal timing, dose and duration of I VIg therapy are needed.