Plasmapheresis in the complex treatment of pharmacoresistant epilepsy in children

A method of therapeutical plasmapheresis (TP) was used in the treatment of 28 patients, aged 4-16 years, with symptomatic and cryptogenic forms of epilepsy, including 3 patients with generalized and 25 patients with partial epilepsy. Local anatomic brain lesions on MRI were not found in cases with pharmacoresistant epilepsy with signs of toxic effect of antiepileptic drugs (AED). Neurological and somatic status of patients as well as frequency of seizures were assessed during the treatment. The use of TP allowed to remove toxic effects and reduce the frequency of seizures by 75% in 7 (25%) patients, the changes being stable over time. However in other cases the positive changes, including frequency of seizures, were temporary and followed by a return to the initial state. The use of TP, along with AED therapy, did not cause the changes of AED blood concentrations. The authors conclude that assignment to TP in epilepsy needs further substantiation, especially in case of children.