Can barbiturate anaesthesia cure infantile spasms?

Five patients with infantile spasms and hypsarrhythmia and one with Lennox-Gastaut syndrome were treated with brief thiopentone anaesthesia as the primary treatment of infantile spasms. Thiopentone (30 mg/kg) was given intravenously and burst suppression was reached in EEG in three patients by this dose. The results were disappointing. In three patients a transient beneficial effect on spasms and hypsarrhythmia was seen, but all patients relapsed. Three other patients had anaesthesia for surgery. The spasms ceased and hypsarrhythmia disappeared dramatically, and the effect was permanent. The possible mechanisms of the therapeutic effect are discussed. It seems advisable to give anaesthesia and surgery prior to steroid treatment in any case where the both are needed.