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Infantile Spasms Treated with Intravenous Methypredinsolone Pulse

Afagh Hassanzadeh Rad1, Vahid Aminzadeh1

  • 1Pediatrics Growth Disorders Research Center, School of Medicine, 17th Shahrivar Hospital, Guilan University of Medical Sciences, Rasht, Iran.

Iranian Journal of Child Neurology
|July 13, 2017
PubMed

Insights

Intravenous methylprednisolone pulse therapy showed promise for infantile spasms, with 60% of infants achieving early remission. However, long-term seizure control varied, highlighting the need for further research into effective infantile spasms treatments.

Area of Science:

  • Pediatric Neurology
  • Neonatal Care
  • Clinical Pharmacology

Background:

  • Infantile spasms (IS) often face diagnostic delays, negatively impacting long-term prognosis.
  • Early intervention is crucial for improving outcomes in infants with IS.
  • Intravenous methylprednisolone pulse therapy is explored as a treatment option.

Purpose of the Study:

  • To evaluate the efficacy of intravenous methylprednisolone pulse therapy in infants diagnosed with infantile spasms.
  • To assess the speed of spasm control and the resolution of hypsarrhythmia.

Main Methods:

  • A case series of 20 infants with infantile spasms treated at 17-Shahrivar Hospital, Rasht, Iran.
  • Treatment followed the Mytinger protocol: 3 days of methylprednisolone pulse followed by 56 days of oral prednisolone.
  • Outcomes measured were spasm control and hypsarrhythmia omission on EEG during sleep.

Main Results:

  • The study included 11 females (55%) and 9 males (45%) with a mean age of 4.95 months.
  • Mean time to rapid remission was 4.41 days, with 60% of patients achieving early remission.
  • Complete seizure control after 24 months was observed in 15% of patients; 25% had occasional seizures controlled by other anticonvulsants, and 60% showed no response.

Conclusions:

  • Methylprednisolone is a viable treatment option for infantile spasms due to its ease of administration, low cost, and accessibility.
  • While initial remission rates were promising, long-term seizure control remains a challenge.
  • Further investigation into optimal treatment strategies for infantile spasms is warranted.
Abstract

Keywords:
AdministrationInfantile spasmsIntravenousPrednisolone

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