Melatonin effect on seizures in children with severe neurologic deficit disorders.

OBJECTIVE

Recently, melatonin has been associated with antiepileptic activity, most probably because of its antioxidant activity as a free radical scavenger. This study aimed to expand the clinical experience with melatonin as an antiepileptic drug (AED) in humans.

METHODS

Six children (aged 2-15 years), with severe intractable seizures, were treated with 3 mg of oral melatonin 30 min before bedtime, in addition to their previous AED treatment for 3 months. A diary of clinical seizure activity (time of day, duration, and type) was kept by parents for a month before and during treatment. Five patients underwent a baseline polysomnography, and three also were monitored during melatonin treatment.

RESULTS

With the exception of the parents of one child, all reported a significant clinical improvement in seizure activity during treatment, particularly during the night. Sleep studies showed a decrease in epileptic activity in two of the three patients who were monitored during treatment, and a change of sleep efficiency from 84.2% to 89.7% (NS). Improvement in daytime behavior and in communication abilities was reported by parents, although it was not objectively measured.

CONCLUSIONS

This clinical observation adds to the growing data showing the antiepileptic effect of melatonin. However, owing to the paucity of well-controlled studies, using melatonin as an AED should be limited to this specific group of patients with intractable seizures.