potassium-bromide and Epilepsies--Partial

A 5-month-old boy with migrating partial seizures in infancy acquired bromoderma 4 weeks after initiating potassium bromide (KBr) therapy (60mg/kg/day). Erythematous pustules appeared on the forehead within a few days of attaching electroencephalography electrodes, and on the cheek at the site of nasogastric tube fixation. These later developed into vegetant plaques. Bromoderma aggravated at the site of skin biopsy that was performed 4 weeks after KBr termination. Bromoderma tuberosum should be recognized widely, considering the increasing use of KBr for treating intractable childhood epilepsy.

Topics: Bromides; Dermatitis, Exfoliative; Drug Eruptions; Epilepsies, Partial; Humans; Infant; Male; Potassium Compounds; Seizures

Topics: Bromides; Diagnosis, Differential; Electroencephalography; Epilepsies, Partial; Humans; Infant; Magnetic Resonance Imaging; Potassium Compounds; Prognosis

We evaluated potassium bromide's (KBr's) efficacy and tolerability for pediatric refractory epilepsy.. We retrospectively reviewed the records of 42 patients treated with KBr in our hospital between 2008 and 2016 (age: 4 months to 19 years; mean: 6.2 years). Thirteen of them had 2 seizure types. The treatment durations ranged from 1 month to 6 years (mean: 15.0 months).. KBr had an excellent effect (seizure-free status) in 3 patients (7.1%), a moderate effect (>50% reduction in seizure frequency from the pretreatment baseline) in 21 patients (50.0%), and no effect (<50% reduction in seizure frequency from the pretreatment baseline) in 18 patients (42.9%). The effective daily doses ranged from 20 to 80 mg/kg (mean: 50.0 mg/kg). KBr was effective in 59.1% patients with generalized epilepsy (n = 22), 55.6% patients with focal epilepsy (n = 18), and both patients with Dravet syndrome. An excellent or moderate effect was found in 72.2% patients with tonic seizures (n = 18), 66.6% patients with generalized tonic-clonic seizures (n = 6), 75.0% patients with secondary generalized seizures (n = 4), 46.2% patients with focal seizures (n = 13), and 20% patients with infantile spasms (n = 10) but no patients with myoclonic seizures (n = 2). Adverse effects including drowsiness, excitement, and rashes were reported in 13 patients (31.0%).. These findings suggest that KBr is particularly effective for tonic seizures, generalized tonic-clonic seizures, and secondary generalized seizures. Although the adverse effects need further attention, KBr should be considered for pediatric refractory epilepsy.

Topics: Adolescent; Anticonvulsants; Bromides; Child; Child, Preschool; Drug Resistant Epilepsy; Epilepsies, Partial; Epilepsy, Generalized; Female; Humans; Infant; Male; Potassium Compounds; Retrospective Studies; Seizures; Treatment Outcome; Young Adult

Topics: Adolescent; Anticonvulsants; Bromides; Child; Child, Preschool; Drug Evaluation; Drug Therapy, Combination; Epilepsies, Myoclonic; Epilepsies, Partial; Epilepsy, Tonic-Clonic; Humans; Male; Potassium Compounds; Retrospective Studies; Treatment Outcome

We present six patients with epilepsy of infancy with migrating focal seizures (EIMFS) and provide a comprehensive evaluation of potassium bromide therapy.. Between February 1, 2007 and July 31, 2012, six patients who met the diagnostic criteria of EIMFS were treated with potassium bromide. Potassium bromide was added to other antiepileptic drugs (AEDs) in doses ranging from 30 to 80 mg/kg/day. Plasma bromide concentration was monitored. A therapeutic bromide concentration between 75 and 125 mg/dL was considered to be ideal.. Four of six children responded well to bromide. One of these patients became seizure free, but remained severely mentally impaired. Two boys, currently 4 and 6 years of age, respectively, have monthly seizures as well as axial hypotonia and severe language impairment. The fourth child responded well to bromide, having only weekly seizures and moderate psychomotor retardation. The patient who became seizure free improved visual contact and head control. In the other three patients with good control, the seizures became focal without secondary generalization and status epilepticus and hospital admission was not required. The remaining two patients did not respond well to bromide. Adverse effects were seen in three cases: vomiting in one, drowsiness in another, and acneiform eruption in the face in the remaining patient. Adverse effects resolved with dose reduction.. Early treatment with bromides should be considered in EIMFS to control the seizures and status epilepticus and to avoid progressive cognitive impairment. Potassium bromide is an old AED. Plasma concentration monitoring should be considered.

Topics: Anticonvulsants; Brain; Bromides; Child; Child, Preschool; Electroencephalography; Epilepsies, Partial; Female; Humans; Male; Potassium Compounds; Treatment Outcome

The syndrome of malignant migrating partial seizures in infancy is a rare epileptic syndrome with a devastating course characterized by early onset of continuous pharmacoresistent multifocal seizures arising from multiple independent sites of both hemispheres with unknown etiology.. A 2-month-old boy with the characteristic clinical and electroencephalograph pattern of migrating partial seizures in infancy was treated with potassium bromide. His seizures were unresponsive to the conventional and new generation antiepileptic drugs.. The seizure frequency was reduced markedly with potassium bromide.. Potassium bromide, an old antiepileptic drug, is useful in the treatment of malignant migrating partial seizures in infancy.

Topics: Anticonvulsants; Bromides; Electroencephalography; Epilepsies, Partial; Humans; Infant; Male; Potassium Compounds

A 3-month-old male and a 4-month-old female infant with intractable seizures were diagnosed as having malignant migrating partial seizures in infancy (MMPSI) with developmental arrest on the basis of characteristics of symptoms, clinical courses and EEGs. We treated these two patients with potassium bromide (80 mg/kg) after conventional antiepileptic drugs failed to adequately control the seizures. The potassium bromide therapy resulted in complete control of seizures in one patient, and more than 95% reduction in seizure frequency in the other.

Topics: Bromides; Electroencephalography; Epilepsies, Partial; Female; Humans; Infant; Male; Potassium Compounds

Topics: Adolescent; Adult; Anticonvulsants; Bromides; Child; Child, Preschool; Drug Therapy, Combination; Electroencephalography; Epilepsies, Partial; Epilepsy; Epilepsy, Tonic-Clonic; Evoked Potentials; Female; Humans; Male; Potassium; Potassium Compounds