title: Adrenocorticotropic hormone versus prednisolone in the treatment of infantile spasms post vigabatrin failure.
abstract: The Child Neurology Society/American Academy of Neurology practice parameter has recommended adrenocorticotropic hormone or vigabatrin in the short-term treatment of infantile spasms. When vigabatrin is unavailable or ineffective and adrenocorticotropic hormone is not a treatment option because of the prohibitive cost, other forms of corticosteroids have been considered in the treatment of infantile spasms. This retrospective study reviewed the Hospital for Sick Children's experience with the short-term effectiveness of prednisolone versus adrenocorticotropic hormone in patients with infantile spasms who have failed vigabatrin. The results showed that while adrenocorticotropic hormone was more likely to lead to short-term spasm freedom, there was no difference in the likelihood of longer-term spasm resolution without relapse. These findings can guide clinicians in the treatment of infantile spasms post vigabatrin failure.
authors: The Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Kevin
authors: K
authors: Jones
authors: The Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors: O Carter
authors: OC
authors: Snead
authors: The Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada.
authors: Jennifer
authors: J
authors: Boyd
authors: The Division of Neurology, Department of Pediatrics, The Hospital for Sick Children, Toronto, Ontario, Canada cristina.go@sickkids.ca.
authors: Cristina
authors: C
authors: Go
mesh_terms: D000324:Adrenocorticotropic Hormone / Q000008:administration & dosage* / Q000009:adverse effects; D000927:Anticonvulsants / Q000008:administration & dosage* / Q000009:adverse effects; D015331:Cohort Studies; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D011239:Prednisolone / Q000008:administration & dosage* / Q000009:adverse effects; D019233:Retreatment; D012189:Retrospective Studies; D012640:Seizures / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D013036:Spasms, Infantile / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D013997:Time Factors; D016896:Treatment Outcome; D020888:Vigabatrin / Q000008:administration & dosage
chemical_list: D000927:Anticonvulsants; D000324:Adrenocorticotropic Hormone; D011239:Prednisolone; D020888:Vigabatrin
keywords: corticosteroids; epileptic encephalopathy; vigabatrin failure