Intravenous immunoglobulin may help reduce seizure frequency in some children with drug-resistant epilepsy, according to a retrospective analysis.
The study found that a subset of children with refractory seizures experienced clinically meaningful seizure reduction after long-term treatment with intravenous immunoglobulin, also known as IVIG.
The research was conducted at a tertiary paediatric epilepsy centre and included 60 children aged two to 18 years who received IVIG for at least one year.
Patients with autoimmune encephalitis were excluded, allowing researchers to assess IVIG in a broader group of children with drug-resistant epilepsy rather than focusing only on those with clearly autoimmune epilepsy.
At one year, 36.7 per cent of patients achieved at least a 50 per cent reduction in seizure frequency.
Among the 22 children who responded to treatment, eight became seizure-free, representing 36.4 per cent of responders.
Children in the study had focal seizures, generalised seizures or both seizure types.
Focal seizures were reported in 38.3 per cent of patients, generalised seizures in 36.7 per cent and both seizure types in 25 per cent.
The strongest statistical signal was seen in children with generalised seizures, where seizure reduction after IVIG reached significance.
The researchers said the findings could not be explained by changes in other anti-seizure medicines, suggesting IVIG may have contributed to improvements in selected patients.
However, they noted that the retrospective design means the study cannot prove IVIG directly caused the seizure reductions.
Inflammation and immune dysfunction have been linked to drug-resistant epilepsy, prompting growing interest in immunomodulatory treatments for children whose seizures remain uncontrolled despite standard medicines and, in some cases, surgery.
The exact mechanism behind IVIG’s potential benefit in paediatric epilepsy remains unclear.
The response pattern in the study suggests seizure type may be important, with generalised seizures appearing more responsive than focal seizures.
However, the authors said there is still limited consensus on IVIG as an add-on therapy for children with drug-resistant epilepsy, as previous studies have reported mixed results.
The findings suggest long-term IVIG could be considered as a potential option for carefully selected children with refractory seizures, particularly those with generalised seizures.
Researchers said further prospective studies are needed to clarify which children are most likely to benefit, when treatment should be used, how durable the response is and how safety should be monitored.
The study, by Ebdalla et al, was published in Frontiers in Neurology.