Compliance With Standard Therapies and Remission Rates After Implementation of an Infantile Spasms Management Guideline

Mytinger, John R.; Albert, Dara V.F.; Twanow, Jaime D.; Vidaurre, Jorge; Tan, Yubo; Brock, Guy; Ostendorf, Adam P.

doi:10.1016/j.pediatrneurol.2019.11.016

Cited by 17 publications

(36 citation statements)

References 24 publications

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“…We were concerned to find an increase in use of nonstandard treatments for new-onset infantile spasms. Several rigorous studies have clearly demonstrated that these have lower efficacy than standard agents 9,16 and that delaying effective therapy leads to a permanent decrease in developmental potential. 17 High-dose oral steroids, with or without combination vigabatrin, have seen shown to be efficacious for infantile spasms 18,19 and can be rapidly started if inpatient hospitalization is not possible.…”

Section: Discussionmentioning

confidence: 99%

Care Delivery for Children With Epilepsy During the COVID-19 Pandemic: An International Survey of Clinicians

et al. 2020

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Objective: To evaluate the effect of the COVID-19 pandemic on global access to care and practice patterns for children with epilepsy. Methods: We conducted a cross-sectional, online survey of pediatric neurologists across the world affiliated with the International Child Neurology Association, the Chinese Child Neurology Society, the Child Neurology Society, and the Pediatric Epilepsy Research Consortium. Results were analyzed in relation to regional burden of COVID-19 disease. Results: From April 10 to 24, 2020, a sample of 212 respondents from 49 countries indicated that the COVID-19 pandemic has dramatically changed many aspects of pediatric epilepsy care, with 91.5% reporting changes to outpatient care, 90.6% with reduced access to electroencephalography (EEG), 37.4% with altered management of infantile spasms, 92.3% with restrictions in ketogenic diet initiation, 93.4% with closed or severely limited epilepsy monitoring units, and 91.3% with canceled or limited epilepsy surgery. Telehealth use had increased, with 24.7% seeing patients exclusively via telehealth. Changes in practice were related both to COVID-19 burden and location. Conclusions: In response to COVID-19, pediatric epilepsy programs have implemented crisis standards of care that include increased telemedicine, decreased EEG use, changes in treatments of infantile spasms, and cessation of epilepsy surgery. The long-term impact of these abrupt changes merit careful study.

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Section: Discussionmentioning

confidence: 99%

Care Delivery for Children With Epilepsy During the COVID-19 Pandemic: An International Survey of Clinicians

et al. 2020

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“…However, if patients fail vigabatrin, ACTH or equivalents should be considered given the risk to the infant of delaying appropriate treatment. 58,59 Febrile Seizures…”

Section: Steroids and Adrenocorticotropic Hormone (Acth)mentioning

confidence: 99%

COVID-19: A Review for the Pediatric Neurologist

Christy¹

2020

J Child Neurol

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Children are susceptible to infection with the novel coronavirus SARS-CoV-2. In this time of uncertainty, this review attempts to compile information that may be helpful to pediatric neurologists. This review consolidates current data on the disease associated with SARS-CoV-2, called COVID-19, and information from past coronavirus epidemics, to discuss diseases of pediatric neurology including Guillain-Barre syndrome (acute inflammatory demyelinating polyradiculoneuropathy); central demyelinating diseases like multiple sclerosis and acute disseminated encephalomyelitis; infantile spasms; febrile seizures; and maternal-fetal transmission of virus.

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“…First, if evaluating infantile spasms in the inpatient setting, length of stay may be reduced (and COVID-19 risk minimized) by selection of prednisolone or vigabatrin over ACTH. 62…”

Section: Recommendationsmentioning

confidence: 99%

Management of Infantile Spasms During the COVID-19 Pandemic

et al. 2020

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Circumstances of the COVID-19 pandemic have mandated a change to standard management of infantile spasms. On April 6, 2020, the Child Neurology Society issued an online statement of immediate recommendations to streamline diagnosis and treatment of infantile spasms with utilization of telemedicine, outpatient studies, and selection of first-line oral therapies as initial treatment. The rationale for the recommendations and specific guidance including follow-up assessment are provided in this manuscript. These recommendations are indicated as enduring if intended to outlast the pandemic, and limited if intended only for the pandemic health care crisis but may be applicable to future disruptions of health care delivery.

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Compliance With Standard Therapies and Remission Rates After Implementation of an Infantile Spasms Management Guideline

Cited by 17 publications

References 24 publications

Care Delivery for Children With Epilepsy During the COVID-19 Pandemic: An International Survey of Clinicians

Care Delivery for Children With Epilepsy During the COVID-19 Pandemic: An International Survey of Clinicians

COVID-19: A Review for the Pediatric Neurologist

Management of Infantile Spasms During the COVID-19 Pandemic

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