Abstracts

Alteration of extracellular volume, ion concentration and osmolarity may affect the epileptogenic process. Oral hydration with a slight hypotonic solution helps to mantain cerebral perfusion and may prevent abrupt changes in the intersticial electrolyte concentration that may trigger epileptic activity. This therapy may help stabilize the nonsynaptic mechanisms associated with seizure activity., We treated empirically eight patients with refractory focal or generalized epilepsy using a rice-based oral electrolyte solution therapy at a dose ranging between one to two liters per day, in addition to the standard AEDs. Six other patients fail to comply with therapy or seizure record keeping and were excluded from this report. Concomittant AEDs were either adjusted or discontinued at discretion of the treating physician. Serum electrolytes were obtained both at baseline and during electrolyte therapy., Three children with familial dysautonomia and refractory absence epilepsy became seizure free for one year after therapy with Ceralyte90. All three patients remain on Ceralyte90 therapy for four years. There were occassional absence seizures after AED discontinuation.One patient with juvenile myoclonic epilepsy not able to tolerate traditional AEDs became seizure free on electrolyte therapy for at least one year. One patient with symptomatic generalized refractory epilepsy had over 90% seizure reduction over one year after electrolyte therapy. One child with refractory symptomatic generalized epilesy stpped atypical absence seizures but persist with uncontrolled generalized convultions. One patient with symptomatic generalized epilesy had reduction of cluster seizures preventing hospital admissions after electrolyte therapy through his gastric tube. One patient with symptomatic generalized epilepsy did not improve and discontinued treatment after three weeks of therapy. No significant side effects or complications have been observed during therapy in any of these patients., Rice-based oral electrolyte hydration is a safe novel therapy that may help control seizures in patients with refractory epilepsy. A controlled study is needed to validate this finding. Seizure freedom with empirical treatment in four patients with atypical absences suggests a possible stronger effect in this type of seizures.[table1],