The response patterns of infantile spasms to treatments in 156 patients: Hormonal therapy with intravenous synthetic ACTH appears promising.

Autor:	Alrifai MT; From the Department of Pediatrics (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Bali), Neurology Division, King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, from the College of Medicine (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali, Alsadhan, Alsugheir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali), Riyadh, Kingdom of Saudi Arabia., Al-Rumayyan AR; From the Department of Pediatrics (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Bali), Neurology Division, King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, from the College of Medicine (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali, Alsadhan, Alsugheir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali), Riyadh, Kingdom of Saudi Arabia., Al-Tuwaijri WA; From the Department of Pediatrics (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Bali), Neurology Division, King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, from the College of Medicine (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali, Alsadhan, Alsugheir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali), Riyadh, Kingdom of Saudi Arabia., Baarmah DM; From the Department of Pediatrics (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Bali), Neurology Division, King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, from the College of Medicine (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali, Alsadhan, Alsugheir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali), Riyadh, Kingdom of Saudi Arabia., Asiri SA; From the Department of Pediatrics (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Bali), Neurology Division, King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, from the College of Medicine (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali, Alsadhan, Alsugheir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali), Riyadh, Kingdom of Saudi Arabia., Bali AH; From the Department of Pediatrics (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Bali), Neurology Division, King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, from the College of Medicine (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali, Alsadhan, Alsugheir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali), Riyadh, Kingdom of Saudi Arabia., Alsadhan MA; From the Department of Pediatrics (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Bali), Neurology Division, King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, from the College of Medicine (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali, Alsadhan, Alsugheir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali), Riyadh, Kingdom of Saudi Arabia., Alsugheir SH; From the Department of Pediatrics (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Bali), Neurology Division, King Abdullah Specialist Children's Hospital, King Abdulaziz Medical City, from the College of Medicine (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali, Alsadhan, Alsugheir), King Saud bin Abdulaziz University for Health Sciences, and from King Abdullah International Medical Research Center (Alrifai, Al-Rumayyan, Al-Tuwaijri, Baarmah, Asiri, Bali), Riyadh, Kingdom of Saudi Arabia.
Jazyk:	angličtina
Zdroj:	Neurosciences (Riyadh, Saudi Arabia) [Neurosciences (Riyadh)] 2022 Jan; Vol. 27 (1), pp. 40-44.
DOI:	10.17712/nsj.2022.1.20210116
Abstrakt:	Objectives: To report the efficacy of intravenous (IV) synthetic ACTH (Tetracosactide) in the treatment of infantile spasms. Methods: This is a retrospective chart review of patients with a diagnosis of infantile spasms conducted at the Pediatric Department of King Abdulaziz Medical City (KAMC) in Riyadh, Saudi Arabia, from 01-01-2005 to 31-12-2019. Results: Of the 156 cases, 141 were treated initially with vigabatrin (VGB) with a complete response seen in 42(30%). Synthetic ACTH (Tetracosactide) IV injections were used in a total of 52 cases with response in 25(48%). Of the 35 cases which initially failed with VGB, 20(57%) responded to synthetic ACTH. The injections were used as a first line in 8 cases with response in 6(75%). The response to oral steroids was seen in 4/14(29%) cases. A relapse was seen in 2/42(5%) of patients treated with VGB and in 5/25(20%) of those who were treated with synthetic ACTH. The response was highest in the idiopathic group with 7/7(100%). Epilepsy at 2 years was seen in 26/50(52%) and 50/57(88%) of the responders and non-responders, respectively ( p =0.000). Only 14/156(9%) of cases had a fair neurological outcome. All of them were from the responder group CONCLUSION: The response to VGB is suboptimal, while the response to synthetic ACTH is encouraging making it a good alternative for natural ACTH as a potential first line therapy in infantile spasms. (Copyright: © Neurosciences.)
Databáze:	MEDLINE
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