Treatment Of Infantile Spasms, A Venezuelan Experience

We analyzed the treatment of 25 children with infantile spasm, 52% were males and 48% females. Of the cases studied 80% were symptomatic and 20% cryptogenic. Twenty-three children were treated with synthetic adrenocorticotropic hormone (ACTH), in 15 children the ACTH was administered with antiepileptic drugs and two children received vigabatrin. In the symptomatic cases of West syndrome, we found hypoxic-ischemic encephalopathy, tuberous sclerosis, brain malformations and Down syndrome. ACTH was efficacious in symptomatic infantile spasms and in cryptogenic spasms. The side effects most frequently found were: irritability, edema, Cushingoid obesity (moon face), hypertension and hypokalemia. Vigabatrin was used in patients with tuberous sclerosis and was efficacious in the control of infantile spasms. Infantile spasms should be treated as soon as the diagnosis is made. ACTH is still first-choice treatment in patients with West syndrome. The drug of choice of the treatment of infantile spasms in children with tuberous sclerosis is vigabatrin.