Outcomes among patients with infantile spasms treated with hormonal therapy and adjuvant topiramate versus hormonal...

Area of Science:

• Pediatric Neurology
• Epileptology

Background:

• Infantile spasms (IS) are a severe epilepsy syndrome in infants.
• Hormonal therapy is the standard first-line treatment for IS.
• Topiramate is sometimes used adjunctively to improve seizure control and developmental outcomes.

Purpose of the Study:

• To compare the efficacy of hormonal therapy alone versus combination therapy with topiramate in treating infantile spasms.
• To evaluate the impact of these treatments on seizure resolution and 12-month developmental outcomes.

Main Methods:

• Retrospective review of pediatric patients diagnosed with infantile spasms.
• Data collected included patient demographics, etiology, treatment regimen (hormonal therapy alone vs. combination with topiramate), seizure resolution at 1, 6, and 12 months, and developmental outcomes at 12 months.
• Statistical analysis compared outcomes between treatment groups.

Main Results:

• Of 55 patients meeting inclusion criteria, 37 received combination therapy and 18 received hormonal therapy alone.
• Spasm resolution rates were comparable between the groups, irrespective of etiology.
• No significant difference in 12-month developmental outcomes was observed between patients treated with hormonal therapy alone versus those receiving adjunct topiramate.

Conclusions:

• Combination therapy with topiramate did not demonstrate added benefit over hormonal therapy alone for infantile spasms in this cohort.
• Hormonal therapy alone appears to be a sufficient treatment option for infantile spasms regarding seizure control and developmental outcomes.
• Further research may be warranted to identify specific subgroups that could benefit from combination therapy.