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[Infantile spasms: experience in 13 cases]
1Serviço de Neurologia Infantil, Centro Geral de Pediatria, Fundação Hospitalar do Estado de Minas Gerais, Belo Horizonte, Brasil.
Insights
Infantile spasms, a serious childhood condition, showed excellent initial response to ACTH treatment. However, a high recurrence rate necessitates further therapeutic strategies and highlights the risk of neurodevelopmental delays.
Area of Science:
- Pediatric Neurology
- Epileptology
Context:
- Infantile spasms represent a severe childhood epilepsy with uncertain outcomes.
- This study reviews a 1997 cohort from Belo Horizonte, Brazil.
Purpose:
- To evaluate the efficacy and safety of ACTH in treating infantile spasms.
- To explore treatment outcomes, recurrence rates, and neurodevelopmental impact.
Summary:
- Twelve symptomatic and one cryptogenic infantile spasm case were treated with 6-week ACTH therapy and oral antiepileptics.
- ACTH demonstrated excellent initial results with manageable side effects.
- A 55% recurrence rate was observed, with vigabatrin effective in 4 of 5 cases as a second-line treatment.
- All cases exhibited neuropsychomotor development retardation.
Impact:
- ACTH is effective for initial infantile spasm control.
- High recurrence rates underscore the need for long-term management strategies.
- Neuropsychomotor retardation is a significant complication requiring ongoing assessment.
Abstract:
Infantile spasms are typical crisis found in the childhood being a serious pathology with an obscure prognosis. We present the experience of the Service of Neuropediatrics in the Pediatric General Center, Belo Horizonte - Brasil, during the year of 1997, with a review of the literature about. After appropriate propaedeutics, were found 12 cases considered symptomatics and 1 case cryptogenic. All these cases were treated with ACTH during 6 weeks associated with oral antiepileptic drugs in mono or polytherapy for maintenance. We had excellent results using ACTH at the beginning of the treatment, obtaining good results in all of the cases with some side effects that were not important enough to interrupt the treatment. However, there was a recurrence rate of 55% and vigabatrin was used as second option, controlling 4 of the 5 cases. All the cases showed retardation of the neuropsychomotor development.