Guideline Update: Medical Treatment of Infantile Spasms

Updated evidence-based guidelines confirm ACTH and vigabatrin as the only effective short-term treatments, with “the sooner, the better” as the treatment motto.

The American Academy of Neurology and the Practice Committee of the Child Neurology Society have updated their 2004 guidelines on the treatment of infantile spasms (IS), to address persistent large practice variability and identify still-unanswered questions. From a systematic review of the literature from 2002 through 2011, the authors identified 26 articles for analysis. All cases of IS were classified as either symptomatic or cryptogenic (including idiopathic cases). The authors used meta-analysis to compare efficacy among studies.

The main findings are as follows:

Adrenocorticotropic hormone (ACTH) is the only corticosteroid treatment with sufficient evidence to support a recommendation for treatment of IS.
Low-dose ACTH is probably as eff…

Reviewing Author

Robert C. Knowlton, MD, MSPH

Disclosures

Consultant/Advisory BoardMore Health, Inc.; The Alliance of Medical Companies

Grant/Research SupportNIH Small Business Innovation Research

Leadership Positions in Professional SocietiesSouthern Epilepsy & EEG Society (Treasurer)

Robert C. Knowlton, MD, MSPH

Disclosures

Consultant/Advisory BoardMore Health, Inc.; The Alliance of Medical Companies

Grant/Research SupportNIH Small Business Innovation Research

Leadership Positions in Professional SocietiesSouthern Epilepsy & EEG Society (Treasurer)