P1-32 Longitudinal change of Thyroid hormone levels in children with epilepsy on ketogenic diet Yun-Jin Lee, Young Mi Kim, Gyu Min Yeon, Joo Hyun Kong, Sang Ook Nam. Department of Pediatrics, Pusan National University School of Medicine, Yangsan, South Korea Objective: To evaluate the prevalence of hypothyroidism and the change of thyroid hormone level in the children with epilepsy on ketogenic diet (KD). Methods: The level of serum free thyroxine (fT4) and thyroid-stimulation hormone (TSH) were measured at the start of KD and at 6e12 months intervals in children with intractable epilepsy. Hypothyroidism was defined as fT4 level <0.8 ng/dL and TSH level >7.0 uIU/mL. Results: A total of 21 chil- dren (13 boys, 8 girls) were enrolled in the study. Mean age of onset of seizure was 1.4 ± 1.5 years, mean age of start of KD was 3.4 ± 2.5 years and mean duration of KD was 2.1 ± 1.5 years. The patients of hypothyroidism with only decrease of fT4 at baseline levels were 2 (9.5%) and at last follow-up were 2 (9.5%). Overall, there was no significant longitudinal change of the mean fT4 (0.95 ± 0.25 vs 1.00 ± 1.00, p ¼ 0.21) and TSH (3.06 ± 1.32 vs 2.42 ± 2.42, p ¼ 0.06) levels from start of KD to last follow-up. Gender, age of seizure onset, duration of KD, ratio of KD, etiologies, baseline seizure fre- quency, seizure outcome after KD, type of antiepileptic drugs, and obesity did not affect the longitudinal change of fT4 and TSH from baseline to last follow-up during KD. The patients with younger age of <1 year at start of seizures (À0.11 ± 0.21 ng/dL, p ¼ 0.02), or with younger age of <2 years at start of KD À(À0.18 ± 0.18 ng/dL, p < 0.01), or with higher levels of triglyceride however, had a sig- nificant decrease for the fT4 levels during KD (À0.14 ± 0.18 ng/dL, p < 0.01). Conclusion: No significant longitudinal change of the levels of thyroid hormone were observed in pediatric epilepsy on the KD. However, we recommend the long-term monitoring of the thyroid hormone levels, especially in children with earlier onset of seizures, earlier start of KD, and higher triglyceride levels. http://dx.doi.org/10.1016/j.ejpn.2017.04.807 P1-33 Treatment of epilepsy of infancy with migrating focal seizures associated with a novel CDKL5 mutation with potassium bromide O. U ¨ nver, G. Yes ‚il, Z. € Ozger, G. Sa ger, G. Thomas, B. Kutlubay, D. Tu ¨ rkdo gan. Department of Pediatric Neurology, University of Marmara, Istanbul, Turkey Objective: We present here a 2-month-old girl with epilepsy of infancy with migrating focal seizures associated with a novel CDKL5 mutation treated with potassium bromide. Methods: A 2- month-old girl was admitted with seizures. The seizures started with clonic arm and leg jerks, usually starting at the left side, migrating to the right side and twitches of the eyelids and mouth to one side. Flushing of one side of the face accompanied some seizures. The seizures were prolonged with episodes of status epilepticus and were refractory to either conventional or new generation antiepileptic drugs. A genetic analysis revealed a novel CDKL5 mutation. Neurological examination revealed axial hypo- tonia with head lag and poor eye contact. Potassium bromide was started with 50 mg/kg/d twice daily and the dosage was gradually increased to 80 mg/kg/d. Phenobarbital was decreased gradually at the same time. After 3 weeks of bromide therapy the patient was seizure-free. However, the therapy was discontinued because the parents could not supply the drug, which is imported from abroad. Refractory seizures started after 3 weeks of discontinua- tion. The therapy was started again. However, the seizures were unresponsive and 3 slightly erythematous and multiloculated nodules between 0,8 cme1cm diameters arised on the right cheek, left fore-arm and dorsum of left hand on the third month of the therapy. Potassium bromide was stopped immediately and the skin lesions were resolved within 3 months and no new lesions were seen. Results: Potassium bromide stopped the episodes of status epilepticus and the patient was seizure-free. However, restarted therapy after discontinuation did not stop the seizures and severe cutaneous side effects were observed leading to discontinuation of therapy. Conclusion: Potassium bromide therapy is effective in the treatment of epilepsy of infancy with migrating focal seizures, nevertheless patients should be moni- tored closely for the potential side effects. http://dx.doi.org/10.1016/j.ejpn.2017.04.808 P1-34 TSC cases in Kazakhstan: Treatment approaches Altyngul Akhanova, Altynshash Jaxybayeva, Raushan Kenzhegulova, Layzzat Baigazieva. UMC National Research Center for Mother and Child Health, Kazakhstan Objective: Treatment approaches to TSC at children of early ages in Kazakhstan. Methods: The retrospective analysis of TSC cases in 2016 at National Research Center of Mother and Child health, Astana, Kazakhstan. Results: 11 TSC cases were admitted at the Center at 2016 aged from 4 months to 7 years. 7 boys and 4 girls (a ratio 1:2). All patients had seizures as a main clinical symptom. Based on the onset of seizures the patients were divided into two groups. The first group of patients consist of 6 children (55%) with early onset of seizures (aged from 2 weeks up to 5 months) had an epileptic (infantile) spasms as a prevalent type of seizures (83,3%). The second group of patients consist of 5 children with late onset of seizures started at 7 months up to 3 years predominantly had a focal tonic seizures. In 3 cases the rabdomioma of heart at the birth has been revealed. In 6 cases single hypopigmented spots of a body at the birth, with increasing amount of spots with age. Also 1 patient with tumorous knots on a face and 1 patient with a gemangiom were observed. In all these cases on brain MRI showed multiple sub- endymal tubers. Patients received various anticonvulsant therapy with different effect. 100% lost all skills and developed a global delay. Conclusion: The early onset of seizures (up to 5 months) correlated with existence of epileptic (infantile) spasms resistant to therapy. The best choose for treatment was hormonal therapy. The late onset of seizures (after 7 months) correlated with focal type of seizures and were treated with valproates, lamotrigine. http://dx.doi.org/10.1016/j.ejpn.2017.04.809 P1-35 Alternative medications for epilepsy of infancy with migrating focal seizures; Potassium bromide and ketogenic diet _ Ipek Polat, Muge Ayanoglu, Derya Okur, Pinar Edem, Cem Paketci, Erhan Bayram, Uluc ¸ Yis ‚ , Semra Hız Kurul. Dokuz Eylul University School of Medicine Department of Pediatrics, Division of Pediatric Neurology Epilepsy of infancy with migrating focal seizures (EIMFS) is a rare and severe epiletic encephalopathy. Randomly migrating focal seizures with migrating epileptic discharges made the diagnosis of EIMFS. Pharmacoresistancy is a major problem. There are few reports about partial effects of some antiepileptics. Here we report european journal of paediatric neurology 21 (2017) e30 ee42 e36