Melatonin effect on seizures in children with severe neurologic deficit disorders

Purpose: Recently, melatonin has been associated with antiepileptic activit y, most probably because of its antioxidant activity as a free radical scav enger. This study aimed to expand the clinical experience with melatonin as an antiepileptic drug (AED) in humans. Methods: Six children (aged 2-15 years), with severe intractable seizures, were treated with 3 mg of oral melatonin 30 min before bedtime, in addition to their previous AED treatment for 3 months. A diary of clinical seizure activity (time of day, duration, and type) was kept by parents for a month before and during treatment. Five patients underwent a baseline polysomnogr aphy, and three also were monitored during melatonin treatment. Results: With the exception of the parents of one child, all reported a sig nificant clinical improvement in seizure activity during treatment, particu larly during the night. Sleep studies showed a decrease in epileptic activi ty in two of the three patients who were monitored during treatment, and a change of sleep efficiency from 84.2% to 89.7% (NS). Improvement in daytime behavior and in communication abilities was reported by parents, although it was not objectively measured. Conclusions: This clinical observation adds to the growing data showing the antiepileptic effect of melatonin. However, owing to the paucity of well-c ontrolled studies, using melatonin as an AED should be limited to this spec ific group of patients with intractable seizures.