Seizure Outcome in Children with Infantile Spasm

Seizure in infantile spasm

Abstract

Background: Infantile Spasm (IS) is a unique age specific epileptic encephalopathy of infancy leading to uncontrolled seizures and mental retardation. Corticosteroid and adrenocorticotropin have long been used in the treatment of infantile spasm. Vigabatrin (VGB), a suicidal inhibitor of GABA transaminase, was found to be very effective in the control of spasms. Other drugs have uncertain efficacy in controlling seizure.
Objective: To assess the seizure outcome in children with infantile spasm after treatment.
Methods: This observational study was done in a specialised paediatric neurology clinic of the Anwar Khan Modern Hospital, Dhaka. Documents of children with diagnosis of infantile spasm who was brought from November 2002 to August 2009 were reviewed. Children suspected as neuro-metabolic or neuro-degenerative disease were excluded. Also, if the children did not turn up at all or came for follow up only once within 3 months after receiving treatment were excluded from the study.
Results: A total of 110 children were enrolled in this study. Sixty nine percent children developed spasm within 3 months to 1 year of age. Mean age at first and at last examination was 10.9 months and 2.1years respectively. In 80 (72.7%) cases, seizure was ‘completely controlled’ and in 9 (8.2%) it was ‘much controlled’. But in 21(19.1%) cases the seizure was ‘not controlled’ or ‘poorly controlled’. Oral prednisolone controlled seizure in 46 (41.8%) cases. ACTH was tried in 17 (15.5%) children. Of these, in five (4.5%) cases seizure was completely cured. Out of 32 (29.1%) babies where vigabatrin was tried , 21 (19.1%) cases responded to vigabatrin . Seizure was controlled in 10 (9.1%) cases with combination of other drugs.
Conclusion: Oral prednisolone, a cheaper drug, can effectively be used as a first choice for the control of infantile spasm. Vigabatrin is good but very costly.

Bangladesh Med Res Counc Bull 2021; 47(3): 244-249