ABSTRACT

Objectives:

To compare according to clinical and EEG response to their treatment regimens of cases who were diagnosed as infantil spasms.

Patients and Methods:

In present study 84 pediatric patients with infantile spasms (54 males, 30 females) were explored according to their features, treatment regimens, clinical and EEG responses. Patients were compared according to use of ACTH+B6 or vigabatrin.

Results:

Mean ages of patients were 8.9±7.2 mounts, complaint ages 7.5±5.3 mounts, following period 33.5±27.5 mounts. According to etiology symptomatic group was 77.4% (hypoxic-ischemic encephalopathy-36.9%). Mental motor retardation was in 91.7% of cases. In the 51 patients which were given ACTH+B6 firstly, there were 58.8% complete, 33.3% partial and 7.8% poor clinical responses. Nineteen point six percent improvement, 19.6% epileptic focus after improvement, 54.9% epileptic focus, 5.9% no improvement were seen as EEG responses in the same patients. In the 31 patients which were given vigabatrin firstly, there were 22.6% complete, 29% partial and 48.5% poor clinical responses, 12.9% improvement, 6.5% epileptic focus after improvement, 32.2% epileptic focus, 48.4% no improvement as EEG responses. There were much more poor clinical and EEG responses in the vigabatrin group (p<0.05). After addition of ACTH+B6 to 26 of that vigabatrin cases, we obtained 69.2% complete, 23.1% partial and 7.7% poor clinical responses, 15.4% improvement, 23.1% epileptic focus after improvement, 53.8% epileptic focus, 7.7% no improvement as EEG responses. Poor clinical and EEG responses were decreased significantly in the cases who was added ACTH+B6 (p<0.05).

Conclusion:

In our study ACTH+B6 therapy has significantly better effect than vigabatrin in infantile spasms treatment.