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Treatment of infantile spasms

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Opinion statement

Infantile spasms are associated with a diverse range of conditions, and treatment options are available. However, outcomes remain generally poor, particularly for those with symptomatic etiologies. First-line therapy is considered to be hormonal (adrenocorticotropic hormone; ACTH), which some evidence suggests is more effective when started early. However, side effects may place limits on its use acutely and long-term. There is additional evidence for vigabatrin, specifically for infantile spasms secondary to tuberous sclerosis complex. In refractory cases, candidacy for surgical management should be explored, along with new-generation anticonvulsants (eg, topiramate, zonisamide) and the ketogenic diet. There is urgent need for further treatment trials comparing anticonvulsants with ACTH and a satisfactory animal model for the study of spasms.

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Authors and Affiliations

  1. Department of Pediatric Neurology, Johns Hopkins Hospital, 600 North Wolfe Street, Jefferson 123, 21287, Baltimore, MD, USA

    Eric H. Kossoff MD

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  1. Philip J. Overby MD
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  2. Eric H. Kossoff MD
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Overby, P.J., Kossoff, E.H. Treatment of infantile spasms. Curr Treat Options Neurol 8, 457–464 (2006). https://doi.org/10.1007/s11940-006-0035-5

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  • DOI: https://doi.org/10.1007/s11940-006-0035-5

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