Efficacy of bromide for intractable epilepsy in childhood.

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The antiepileptic effect of bromide was studied in 20 epileptic patients with refractory seizures. Their ages were ranged from one year 5 months to 22 years (mean 9 years 7 months). Serum bromide levels were also determined in 14 patients. The types of epilepsy were partial epilepsy in 10 and secondary generalized epilepsy in 10 cases. The seizure types were secondarily generalized tonic clonic convulsions (pGTC) in 13, tonic seizures in 10, myoclonic seizures in 7 and atypical abscences in 6 cases. Six of 13 cases with pGTC and one with tonic seizure showed more than 50% reduction of seizure frequency. Two with pGTC and one with myoclonic seizure had slight improvement of seizure frequency. In one case with Lennox-Gastaut syndome, a transient improvement of frequent tonic seizures was observed. There was no direct relationship between serum bromide levels and clinical response. Side effects were observed in 5 cases (acneform rash in 3, diarrhea in one and drowsiness in one) between 1 to 5 months after the initiation of bromide therapy, despite their plasma bromide levels were not so high.<BR>Although bromide has some untoward effects, the present study suggests this compound is an effective and benefical anticonvulsant for treatment of intractable epilepsy with pGTC.
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