Abstract
This paper reviews the use of immunoglobulin and adrenocorticotropic hormone in the management of refractory epilepsy, as alternative therapies for these patients.
This application is clearly supported by physiopathology, the inflammatory phenomena associated to epilepsy are clearly known, they act by blocking inhibitory mechanisms and allowing for neuronal excitation. There are comprehensive descriptions about the successful use of immunoglobulin in disorders such as Rasmüssen’s encephalitis, Lennox-Gastaut syndrome, Landau-Kleffner syndrome and epilepsy with variable foci, and it has been also used as rescue treatment in West syndrome.
It is the treatment of choice in the United States, and there is no statistical difference in effectiveness in this syndrome when compared with vigabatrin.
In order to use these treatments, intercurrent infections should be ruled out and it is necessary to monitor closely its use to prevent complications.
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