Vigabatrin fherapy in infantile spasms

Abstract

Infantil spasm (IS) is one of the most refractory type of seizures in childhood. Spasms, characteristic EEG pattern of hypsarythmia and progressive psychomotor retardation are three principal symptoms of IS. ACTH or corticosteroid is effective and standart treatment for IS; however severe side effects may be frequent and important. Vigabatrin (VGB) has been shown to be effective in the treatment of IS and is well tolerated. In our study, efficacy and safety of VGB was evaluated in 41 children with IS. Twenty-four patients were males, 17 were females. Follow-up period ranged from 6 to sixty months. Physical and neurologic examination as well as routine hematologic studies, EEG and neuroimaging studies were performed in all patients. VGB was initiated as first drug in 18 patients; as second drug in 23 patients whose seizures had recurred after ACTH therapy. Overall, fourteen patients were considered in cryptogenic IS group, twenty seven patients symptomatic. Seven of the cryptogenic IS group and twelve of the symptomatic IS group were seizure-free. No improvement was seen in 9 cases. Adverse effects were slight and transient. VGB appears to be an effective and safe alternative antiepileptic drug in IS treatment.