Long‐term Cognitive Outcomes of a Cohort of Children with Cryptogenic Infantile Spasms Treated with High‐dose Adrenocorticotropic Hormone

Kivity, Sara; Lerman, Pinchas; Ariel, Raya; Danziger, Y; Mimouni, Marc; Shinnar, Shlomo

doi:10.1111/j.0013-9580.2004.30503.x

Cited by 183 publications

(164 citation statements)

References 29 publications

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“…Erken tedavinin nöbet kontrolü yanında özellik-le kriptojenik grupta bebeğin gelişimi üzerine olumlu etkisinin gösterilmesi, erken tanı ve uygun tedavinin önemini artırmıştır [33][34][35]. Prognoz en çok altta yatan etiyolojiye bağlıdır.…”

Section: Discussionunclassified

West syndrome: Clinical characteristics and short-term outcome

Yılmaz

2014

J Clin Exp Invest

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Section: Discussionunclassified

West syndrome: Clinical characteristics and short-term outcome

Yılmaz

2014

J Clin Exp Invest

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“…Hormonal therapy seems to be twice as effective as vigabatrin in the group of 'other symptomatic infantile spasms'. In a retrospective study by Kivity et al [10] (Class IV), long-term treatment with high-dose tetracosactide followed by oral corticosteroids for about 9 months resulted in a normal cognitive outcome in all patients when treated within 1 month of the onset of infantile spasms, but only in 40 % when treated later. This study included only cryptogenic patients.…”

Section: Tuberous Sclerosis (Ts)mentioning

confidence: 98%

“…The cryptogenic group may have a normal outcome in up to 100 % of patients if the effective treatment has been started within 1 month [10]. The symptomatic group can have a favourable outcome in approximately 20 % of patients [11].…”

Section: Introductionmentioning

confidence: 99%

Recent Advances in the Pharmacotherapy of Infantile Spasms

Riikonen

2014

CNS Drugs

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Adrenocorticotrophic hormone (ACTH), oral corticosteroids and vigabatrin are now first-line treatments for infantile spasms in the US and Europe. There is now increased knowledge regarding the role of ACTH, corticosteroids and vigabatrin (e.g. efficacy, doses, side effects, treatment in specific aetiological subtypes of infantile spasms), and other antiepileptic drugs (i.e. topiramate, valproate, zonisamide, sulthiame, levetiracetam, lamotrigine, pyridoxine, ganaxolone), as well as adjunctive flunarizine and novel drugs not yet in clinical use for infantile spasms (i.e. pulse rapamycin and melanocortin receptor agonists). The existence of a latent period, weeks to months following a precipitating brain insult, raises the possibility of preventive interventions. Recent experimental data emerging from animal models of infantile spasms have provided optimism that new and innovative treatments can be developed, and knowledge that drug treatment can affect long-term cognitive outcome is increasing. The aim of this article is to review recent developments in the pharmacotherapy of infantile spasms and to highlight the practical implications of the latest research.

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“…125 The desirability of rapid control to reduce secondary psychomotor regression or transition to other catastrophic seizure types (e.g., Lennox-Gastaut syndrome) is a priority in the treatment of patients with IS. 129 Corticotropin or corticosteroids are efficacious in approximately 50 -75% of IS, but the adverse effects of highdose corticosteroids are a concern. 17 Corticosteroids do not completely control spasms in all patients, are associated with appreciable relapse rates, and have serious potential side effects.…”

Section: Refractory Complex Partial Seizures and Infantile Spasmsmentioning

confidence: 99%

Vigabatrin

2007

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Summary: Refractory epilepsies such as infantile spasms (IS) and complex partial seizures (CPS) can have a severe negative impact on the neurological integrity and quality of life of affected patients, in addition to drastically increasing their risk of premature mortality. Early identification of potentially effective pharmacotherapy agents is important. Vigabatrin has been shown to be a generally well tolerated and effective antiepileptic drug (AED) in a wide variety of seizure types affecting both children and adults, particularly those with IS and CPS. A bilateral, concentric constriction of the peripheral visual field characterizes the visual field defect (VFD) associated with vigabatrin, well characterized by numerous studies. This peripheral VFD presents in 30 -50% of patients with exposure of several years; however, most of these patients are asymptomatic. In well-controlled studies, the earliest onset in patients with CPS is 11 months and at 5 months in infants, with average onsets being more than 5 years and 1 year, respectively. Patients with a peripheral VFD retain an average 65°of lateral vision (normal, 90°). The fact that many patients never develop the vigabatrin-related peripheral VFD, despite long-term exposure at high doses, may support the hypothesis that the injury is an idiosyncratic adverse drug reaction (as opposed to a strict dose-or duration-dependent toxicity). Effective testing methods are available to aid in the early detection and management of the peripheral VFD. This article discusses issues of importance to clinical decision-making in the use of vigabatrin to assist the physician and patient in assessing the benefits of vigabatrin therapy and understanding the potential risks of the VFD and uncontrolled seizures.

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Long‐term Cognitive Outcomes of a Cohort of Children with Cryptogenic Infantile Spasms Treated with High‐dose Adrenocorticotropic Hormone

Cited by 183 publications

References 29 publications

West syndrome: Clinical characteristics and short-term outcome

West syndrome: Clinical characteristics and short-term outcome

Recent Advances in the Pharmacotherapy of Infantile Spasms

Vigabatrin

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