The AAN has published evidence–based recommendations for the treatment of infantile spasms that update a 2004 guideline. “Evidence–based Guideline Update: Medical Treatment of Infantile Spasms” appears in the June 12, 2012, issue of Neurology®.
The guideline suggests that the therapy adrenocorticotropic hormone, also known as ACTH, and the antiepileptic drug vigabatrin (VGB) may be effective in the treatment of infantile spasms in children. A low–dose ACTH protocol can be as effective as higher doses and may lower the risk of adverse effects. ACTH may be more effective than VGB as short–term therapy. However, VGB has been shown to be possibly effective in patients with tuberous sclerosis complex. There is not enough evidence to know whether other therapies, alone or combined, are effective for short–term treatment.
The required evaluation includes an EEG for confirmation of the diagnosis.
“The studies point to early diagnosis and thus early intervention as possibly leading to better outcomes long–term,” said guideline lead author Cristina Go, MD, “and that, more specifically, early treatment with ACTH, prednisolone, or VGB may improve long–term cognitive outcomes. As for long–term developmental outcomes, however, hormonal therapy, either with ACTH or prednisolone, possibly outperforms VGB treatment.”
Read the guideline and access PDF summaries for clinicians and patients, a slide presentation, and a clinical example. For more information, contact Julie Cox at firstname.lastname@example.org or (612) 928–6069.