Affiliations: Servicio de Pediatría del Hospital "Felipe
Guevara Rojas", Universidad de Oriente, El Tigre-Anzoátegui,
Venezuela | Unidad de Epilepsia y Encefalografía, Centro
Clínico "Esperanza Paraco", El Tigre-Anzoátegui, Venezuela
Note: [] Correspondence: Dr. José Guevara Campos, Departamento de
Neuropediatria, Hospital "Felipe Guevara Rojas", El Tigre, Anzoátegui
State, 6034, Venezuela. E-mail: joguevara90@hotmail.com
Abstract: We analyzed the treatment of 25 children with infantile spasm, 52%
were males and 48% females. Of the cases studied 80% were symptomatic and
20% cryptogenic. Twenty-three children were treated with synthetic
adrenocorticotropic hormone (ACTH), in 15 children the ACTH was administered
with antiepileptic drugs and two children received vigabatrin. In the
symptomatic cases of West syndrome, we found hypoxic-ischemic encephalopathy,
tuberous sclerosis, brain malformations and Down syndrome. ACTH was efficacious
in symptomatic infantile spasms and in cryptogenic spasms. The side effects
most frequently found were: irritability, edema, Cushingoid obesity (moon
face), hypertension and hypokalemia. Vigabatrin was used in patients with
tuberous sclerosis and was efficacious in the control of infantile spasms.
Infantile spasms should be treated as soon as the diagnosis is made. ACTH is
still first-choice treatment in patients with West syndrome. The drug of choice
of the treatment of infantile spasms in children with tuberous sclerosis is
vigabatrin.