Treating MAE

MAE is a childhood seizure disorder that is often not easily controlled by conventional medications. However there are varying degrees of severity of the condition, and some children may easily respond to the first line AEDs (anti-epileptic drugs) prescribed. Others may need second or even third medications added to achieve complete control, but there will still be some children who fail to respond even to this level of therapy. In some cases a polytherapy regime (more than one medication used at a time) or even each medication used on its own, may actually lead to the onset of increased or paradoxical seizures.

As knowledge of MAE increases, and correct diagnoses are made more readily, the success rate of treatments trialled is gradually but constantly improving. In addition, newer antiepileptic medications are proving highly effective in MAE and this too is contributing to better outcomes for our children.

Various studies over recent years have shown that the ketogenic diet is extremely effective in controlling seizures in children with MAE, and is now considered one of the most successful treatments for the disorder, even more successful, according to some centres, than the more traditional anti-epileptic drugs. Parents who achieved seizure control through AEDs but with bothersome or inhibitory cognitive side effects have also chosen this form of therapy as an alternative to medication. Some children require a combination of the ketogenic diet as well as medication added, others respond completely to the diet alone.

Steroids have also been successfully used as treatment for MAE in some children, either with or without accompanying AEDs. Most widely used is a steroid known as ACTH, an injected steroid previously more commonly used as a treatment for another childhood seizure disorder, Infantile Spasms (West Syndrome). Oral prednisone/prednisolone has also shown tremendous success in seizure control, either as a therapy on it's own, or as a maintenance/weaning agent following a course of ACTH.

There are cases where, regardless of treatment and the state of current seizure control, the child will - either gradually or suddenly - cease having seizures. These children are presumed to be amongst those who have gone into spontaneous remission.

MAE is a syndrome with variable courses and various outcomes, meaning that the treatment each individual child responds to will also be highly variable. There is no 'right' answer that encompasses the whole range of children - each parent in conjunction with their treating physician must therefore be part of the process where they strive for the ideal treatment for their individual child to be found. Reading the experiences of families who have found what's worked for them with seizure control may aid in this process, as hopefully will reading about cases where treatments known to have the potential to aggravate MAE seizures or induce have been involved. ¨