RT Journal Article
SR Electronic
T1 The response patterns of infantile spasms to treatments in 156 patients
JF Neurosciences Journal
JO Neurosciences (Riyadh)
FD Prince Sultan Military Medical City
SP 40
OP 44
DO 10.17712/nsj.2022.1.20210116
VO 27
IS 1
A1 Muhammad T. Alrifai
A1 Ahmad R. Al-Rumayyan
A1 Waleed A. Al-Tuwaijri
A1 Duaa M. Baarmah
A1 Safiyyah A. Asiri
A1 Ahmad H. Bali
A1 Muatassem A. Alsadhan
A1 Shaden H. Alsugheir
YR 2022
UL http://nsj.org.sa/content/27/1/40.abstract
AB Objectives: To report the efficacy of intravenous (IV) synthetic ACTH (Tetracosactide) in the treatment of infantile spasms.Methods: This is a retrospective chart review of patients with a diagnosis of infantile spasms conducted at the Pediatric Department of King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia, from 01-01-2005 to 31-12-2019.Results: Of the 156 cases, 141 were treated initially with vigabatrin (VGB) with a complete response seen in 42(30%). Synthetic ACTH (Tetracosactide) IV injections were used in a total of 52 cases with response in 25(48%). Of the 35 cases which initially failed with VGB, 20(57%) responded to synthetic ACTH. The injections were used as a first line in 8 cases with response in 6(75%). The response to oral steroids was seen in 4/14(29%) cases. A relapse was seen in 2/42(5%) of patients treated with VGB and in 5/25(20%) of those who were treated with synthetic ACTH. The response was highest in the idiopathic group with 7/7(100%). Epilepsy at 2 years was seen in 26/50(52%) and 50/57(88%) of the responders and non-responders, respectively (p=0.000). Only 14/156(9%) of cases had a fair neurological outcome. All of them were from the responder groupConclusion: The response to VGB is suboptimal, while the response to synthetic ACTH is encouraging making it a good alternative for natural ACTH as a potential first line therapy in infantile spasms.