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The use of vigabatrin in infantile spasms in Asian children

S K Tay1, H T Ong, P S Low

  • 1Department of Paediatrics, National University Hospital, 5 Lower Kent Ridge Road, Singapore 119074.

Annals of the Academy of Medicine, Singapore
|March 13, 2001
PubMed

Insights

Vigabatrin shows promise for infantile spasms in Asian children, with over half achieving seizure control. However, a higher maintenance dose may be needed to prevent relapses and manage adverse effects effectively.

Area of Science:

  • Pediatric Neurology
  • Epileptology

Background:

  • Adrenocorticotrophic hormone (ACTH) and prednisolone are established treatments for infantile spasms but cause significant morbidity and are unsuitable for long-term use.
  • Vigabatrin has emerged as a promising alternative, with current suggestions favoring its use as a first-line therapy for infantile spasms.

Purpose of the Study:

  • To evaluate the efficacy and tolerability of vigabatrin in Asian children diagnosed with infantile spasms.
  • To identify potential problems and optimal dosing strategies associated with vigabatrin treatment in this population.

Main Methods:

  • A cohort of 18 Asian pediatric patients with infantile spasms received vigabatrin.
  • Vigabatrin was administered as first-line monotherapy in 8 patients and as add-on therapy in 10 patients.

Main Results:

  • Complete seizure suppression was observed in 39% of patients at 2 weeks and 50% at 4 weeks.
  • A high relapse rate (56%) occurred within 6 months among responders, potentially linked to suboptimal maintenance dosage (average 59 mg/kg/day), with relapsed patients responding to increased doses (83 mg/kg/day).
  • Vigabatrin was generally well-tolerated, with only two patients experiencing somnolence and irritability.

Conclusions:

  • A minimum maintenance dose of 70 mg/kg/day may be required for adequate seizure control in infantile spasms.
  • This dosage adjustment could help mitigate common adverse effects associated with vigabatrin therapy.
Abstract

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