Back to Browse Journals » Neuropsychiatric Disease and Treatment » Volume 5

Current trends in the treatment of infantile spasms

Authors Chang-Yong Tsao

Published Date May 2009 Volume 2009:5 Pages 289—299

DOI http://dx.doi.org/10.2147/NDT.S4488

Published 19 May 2009

Chang-Yong Tsao

Clinical Pediatrics and Neurology, The Ohio State University, College of Medicine, Columbus, Ohio, USA

Abstract: Infantile spasms are an epilepsy syndrome with distinctive features, including age onset during infancy, characteristic epileptic spasms, and specific electroencephalographic patterns (interictal hypsarrhythmia and ictal voltage suppression). Adrenocorticotropic hormone (ACTH) was first employed to treat infantile spasms in 1958, and since then it has been tried in prospective and retrospective studies for infantile spasms. Oral corticosteroids were also used in a few studies for infantile spasms. Variable success in cessation of infantile spasms and normalization of electroencephalograms was demonstrated. However, frequent significant adverse effects are associated with ACTH and oral corticosteroids. Vigabatrin has been used since the 1990s, and shown to be successful in resolution of infantile spasms, especially for infantile spasms associated with tuberous sclerosis. It is associated with visual field constriction, which is often asymptomatic and requires perimetric visual field study to identify. When ACTH, oral corticosteroids, and vigabatrin fail to induce cessation of infantile spasms, other alternative treatments include valproic acid, nitrazepam, pyridoxine, topiramate, zonisamide, lamotrigine, levetiracetam, felbamate, ganaxolone, liposteroid, thyrotropin-releasing hormone, intravenous immunoglobulin and a ketogenic diet. Rarely, infantile spasms in association with biotinidase deficiency, phenylketonuria, and pyridoxine-dependent seizures are successfully treated with biotin, a low phenylalanine diet, and pyridoxine, respectively. For medically intractable infantile spasms, some properly selected patients may have complete cessation of infantile spasms with appropriate surgical treatments.

Keywords: infantile spasms, adrenocorticotropic hormone, oral corticosteroids, vigabatrin

Download Article [PDF] 

Creative Commons License This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution - Non Commercial (unported, v3.0) License. The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed. Permissions beyond the scope of the License are administered by Dove Medical Press Limited. Information on how to request permission may be found at: http://www.dovepress.com/permissions.php

Readers of this article also read:

Inhibition of A/Human/Hubei/3/2005 (H3N2) influenza virus infection by silver nanoparticles in vitro and in vivo [Corrigendum]

Xiang DX, Zheng Y, Duan W, Li XJ, Yin JJ, Shigdar S, O'Connor ML, Marappan M, Zhao XJ, Miao YQ, Xiang B, Zheng CL

International Journal of Nanomedicine 2013, 8:4703-4704

Published Date: 5 December 2013

Vincristine sulfate liposomal injection for acute lymphoblastic leukemia [Corrigendum]

Soosay Raj TA, Smith AM, Moore AS

International Journal of Nanomedicine 2013, 8:4705-4706

Published Date: 5 December 2013

Corrigendum

Mizoguchi T, Ozaki M, Unoki K, Dake Y, Eto T, Arai M

Clinical Ophthalmology 2012, 6:1717-1718

Published Date: 26 October 2012

Do calcifying nanoparticles really contain 16S rDNA?

Shiekh FA

International Journal of Nanomedicine 2012, 7:5051-5052

Published Date: 18 September 2012

Corrigendum

Brief G, Lammich T, Nagel E, Pfennigsdorf S, Spraul CW, Ho S

Clinical Ophthalmology 2012, 6:1271-1272

Published Date: 6 August 2012

Corrigendum

Chen ZQ, Liu Y, Zhao JH, Wang L, Feng NP

International Journal of Nanomedicine 2012, 7:1709-1710

Published Date: 30 March 2012

Corrigendum

Escobar-Chávez JJ, Domínguez-Delgado CL, Rodríguez-Cruz IM

Drug Design, Development and Therapy 2011, 5:487-488

Published Date: 28 November 2011

Corrigendum

Schneider EW, Johnson MW

Clinical Ophthalmology 2011, 5:1315-1316

Published Date: 16 September 2011

Corrigendum

Nelson DA, Ruf A, Oaknin J, Burgansky-Eliash Z, Barash H, Izhaky D, Loewenstein A, Barak A, Bartov E, Rock T, Grinvald A

Clinical Ophthalmology 2011, 5:1317-1318

Published Date: 15 September 2011

Corrigendum: Softec HD hydrophilic acrylic intraocular lens: biocompatibility and precision

Espandar L, Sikder S, Moshirfar M

Clinical Ophthalmology 2011, 5:159-160

Published Date: 6 February 2011