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Efficacy of Treatment for Infantile Spasms: A systematic review

 Song Ji Min  ;  Hahn Jongsung  ;  Kim Se Hee  ;  Chang Min Jung 
 CLINICAL NEUROPHARMACOLOGY, Vol.40(2) : 63-84, 2017 
Journal Title
Issue Date
Adrenocorticotropic Hormone/therapeutic use* ; Anticonvulsants/therapeutic use* ; Combined Modality Therapy ; Diet, Carbohydrate-Restricted* ; Diet, Ketogenic* ; Drug Therapy, Combination ; Humans ; Infant ; Spasms, Infantile/diet therapy* ; Spasms, Infantile/drug therapy*
antiepileptic drugs ; dietary treatment ; drug treatment ; infantile spasms ; West syndrome
Objectives: West syndrome (also known as infantile spasm because of its main seizure type) is a rare form of epilepsy that begins during early infancy. Recent guidelines and reviews on West syndrome recommend the use of adrenocorticotropic hormone steroids, or vigabatrin, as the first-line treatment. However, West syndrome remains to be one of the most challenging epilepsies to treat. Here, we systematically reviewed the current literature obtained during the previous decade. This article provides an overview of the current treatment of infantile spasms. Methods: PubMed and EMBASE were searched to retrieve studies on human published during 2005–2015 and to identify patients with clinical diagnosis of infantile spasms. Drug or diet treatments were used as interventions and comparators. Results: We included 55 studies, of which 1 study was a meta-analysis, 9 were randomized controlled trials, 21 were prospective studies, and 24 were retrospective studies. Topiramate, levetiracetam, zonisamide, and sodium valproate with benzodiazepine (clonazepam or nitrazepam) were found to be potential drugs for treating West syndrome besides adrenocorticotropic hormone, steroids, and vigabatrin. Ketogenic diet and modified Atkins diet were also found to be effective. Conclusions: To date, data regarding the efficacy of treatments of West syndrome still remain limited. Some treatments, including topiramate and ketogenic diet, seem promising besides adrenocorticotropic hormone, steroids, and vigabatrin. Well-designed trials are warranted to validate the findings.
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1. College of Medicine (의과대학) > Dept. of Pediatrics (소아청소년과학교실) > 1. Journal Papers
Yonsei Authors
Kim, Se Hee(김세희) ORCID logo https://orcid.org/0000-0001-7773-1942
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