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Infantile spasms in Down syndrome: good response to a short course of vigabatrin

R Nabbout1, I Melki, B Gerbaka

  • 1Department of Pediatrics, Hôpital Hôtel Dieu de France, Université St. Joseph, Beirut, Lebanon.

Epilepsia
|March 7, 2002
PubMed

Insights

Vigabatrin effectively treats infantile spasms (ISs) in Down syndrome (DS). A six-month treatment course appears sufficient, reducing potential retinal toxicity without relapse.

Area of Science:

  • Pediatric Neurology
  • Clinical Pharmacology

Background:

  • Infantile spasms (ISs) are a severe epilepsy syndrome.
  • Down syndrome (DS) is associated with an increased risk of ISs.
  • Vigabatrin (VGB) is a first-line treatment for ISs but carries risks of visual toxicity.

Purpose of the Study:

  • To assess vigabatrin's efficacy for infantile spasms in Down syndrome.
  • To determine if a shorter VGB treatment duration is feasible.
  • To evaluate the potential for reducing VGB-related retinal toxicity.

Main Methods:

  • Open-label prospective study of five infants with ISs and DS.
  • Vigabatrin administered as first-line monotherapy.
  • Treatment duration limited to six months for spasm-free patients.

Main Results:

  • Four out of five children achieved spasm freedom with VGB.
  • Three children responded within one week of treatment initiation.
  • No relapses occurred during a 2-4 year follow-up after 6-month VGB discontinuation.

Conclusions:

  • Vigabatrin is effective for treating infantile spasms in Down syndrome.
  • A six-month VGB treatment course can be effective and may lower toxicity risks.
  • Early discontinuation after achieving remission is a viable strategy.
Abstract

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