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Vigabatrin as First-Line Treatment for Infantile Spasms Not Related to Tuberous Sclerosis Complex

Kevin Jones1, Cristina Go2, Jennifer Boyd2

  • 1The Division of Neurology, Department of Pediatrics, McMaster Children's Hospital, Hamilton, Ontario, Canada.

Pediatric Neurology
|August 1, 2015
PubMed

Insights

Vigabatrin showed limited short-term effectiveness as a first-line treatment for infantile spasms in infants without tuberous sclerosis complex. However, it was most beneficial for infants with normal development at diagnosis.

Area of Science:

  • Pediatric Neurology
  • Epilepsy Research
  • Clinical Therapeutics

Background:

  • Infantile spasms are a severe, age-specific infant seizure disorder.
  • Current guidelines recommend adrenocorticotropic hormone or vigabatrin for short-term treatment.

Purpose of the Study:

  • To evaluate the short-term efficacy of vigabatrin as a first-line therapy for infantile spasms.
  • Focus on patients without tuberous sclerosis complex.

Main Methods:

  • Retrospective analysis of 61 infants diagnosed with infantile spasms between 2010-2013.
  • Minimum 6-month follow-up from treatment initiation.

Main Results:

  • 30% of infants responded to vigabatrin within 4 weeks; 11% relapsed.
  • 27% were seizure-free at final follow-up.
  • Normal development at diagnosis correlated with vigabatrin response.

Conclusions:

  • Vigabatrin's first-line efficacy for infantile spasms (non-TSC) was not supported.
  • Vigabatrin is most effective in children with normal development at diagnosis.
  • Findings aid clinicians in selecting optimal first-line treatment for infantile spasms.
Abstract

Keywords:
efficacyepileptic encephalopathyinfantile spasmsnontuberous sclerosis complexpredictorsvigabatrin

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