From the Research
Steroids can cause seizures through several mechanisms affecting brain function, including disrupting the balance of electrolytes, altering neurotransmitter systems, and causing fluid retention and hypertension, as reported in the most recent study 1. The use of steroids in adult epilepsy has been systematically reviewed, and the results show that steroids can be effective in improving seizures in some cases, but further research is needed to better understand the effect and benefits of steroids in managing epilepsy 1. Some of the key mechanisms by which steroids can cause seizures include:
- Disrupting the balance of electrolytes in the body, particularly causing hypokalemia (low potassium) and hypomagnesemia (low magnesium), which increase neuronal excitability
- Altering neurotransmitter systems, enhancing excitatory glutamate activity while reducing inhibitory GABA function, creating a pro-seizure state in the brain
- Causing fluid retention and hypertension, potentially leading to posterior reversible encephalopathy syndrome (PRES), which is associated with seizures
- Rapid withdrawal from long-term steroid therapy, which can trigger seizures due to sudden changes in brain excitability It is essential to note that patients with a history of epilepsy, electrolyte disorders, or central nervous system conditions are at higher risk for steroid-induced seizures and should be monitored closely when receiving steroid therapy 2. In pediatric epilepsy, corticosteroid therapy (CT) is used as an alternative approach in cases where conventional antiepileptic drugs are not effective, and the results show that CT can be effective in improving seizures in some cases 3. However, the use of steroids as a treatment for uncontrolled seizures has not been researched widely, and high-level evidence such as Randomized-Controlled Trials investigating the use of corticosteroids in adult epilepsy are required 1. In summary, the use of steroids can cause seizures through various mechanisms, and patients with a history of epilepsy or other risk factors should be closely monitored when receiving steroid therapy.