Antiepileptic drug treatment of West syndrome

We sent questionnaires about current therapy for West syndrome (WS) to 208 institutions at which the pediatric members of the Japan Epilepsy Society were in residence. One hundred twenty-nine institutions (62%) responded. Thirty-eight institutions (29.5%) treated symptomatic and cryptogenic WS differently. Vitamin B6 was the most preferred first-line drug, followed by the combination of vitamin B6 and valproate (VPA) or monotherapy with VPA. ACTH was the third choice among drugs. The combination therapy of vitamin B6 and VPA was effective in 58.3% of the patients with symptomatic WS.