Background: While there are guidelines for the use of intravenous immunoglobulins in
children with Guillain-Barre syndrome and myasthenia gravis based on high-level evidence studies,
data are scarce for the majority of neurologic disorders in this age group. Neuronal antibodies are detected
in children with seizures of autoimmune etiology. Intravenous immunoglobulins with their broad
immunomodulatory mechanism of action could be ideally effective in different forms of immunedysregulated
intractable epilepsies such as autoimmune epilepsy and autoimmune Rasmussen encephalitis.
We conducted a systematic review of the literature for evidence of the use of intravenous immunoglobulins
in a variety of neurologic diseases in childhood.
Method: A comprehensive literature search was conducted using Pubmed as the medical database
source without date range. Prospective studies in pediatric groups including objective measures of
clinical outcomes were systematically selected.
Results: A total of 11 prospective studies were identified in the literature demonstrating a favorable effect
of this therapeutic option in children with drug-resistant epilepsy and in cases of encephalitis. No serious
adverse effects were reported. No prospective studies about the use of intravenous immunoglobulins in
children with demyelinating disorders or neurologic paraneoplasmatic syndromes were found.
Conclusion: In this review, we summarize the recent advances in the field of intravenous immunoglobulins
used in pediatric neurological diseases. Literature data supports a beneficial effect in this age
group. Whilst awaiting the results of large scale studies, administration of intravenous immunoglobulins
could be justified in refractory child epilepsy. Otherwise, its use should be guided by the individual
needs of each child, depending on the underlying neurological disease.