Practice experience in the treatment of infantile spasms at a tertiary care center
| Autor: | Yoshimi Sogawa, Drew Michael Thodeson |
|---|---|
| Rok vydání: | 2014 |
| Předmět: |
Male
Pediatrics medicine.medical_specialty Treatment response Databases Factual Tertiary care Vigabatrin Cohort Studies Epilepsy Developmental Neuroscience Medicine Humans business.industry Medical record Infant Electroencephalography medicine.disease Hormones Clinical trial Treatment Outcome Neurology Child Preschool Pediatrics Perinatology and Child Health Cohort Etiology Anticonvulsants Female Neurology (clinical) business Spasms Infantile medicine.drug |
| Zdroj: | Pediatric neurology. 51(5) |
| ISSN: | 1873-5150 |
| Popis: | Background The current treatment guidelines for treatment of infantile spasms is ambiguous regarding individuals with known etiology and is backed by limited evidence. Recently published survey data reveal diverse treatment variation for infantile spasms. We conducted a retrospective medical record review to better understand the clinical variables which affect treatment selection for new-onset infantile spasms. Methods We systematically extracted demographic data and treatment response of children with new onset infantile spasms over a 3-year period at a single institution. Treatment was divided into three groups: vigabatrin, hormone treatment, and other therapies. Results Our final cohort had 65 patients; 74% had a known etiology. Sixty-two percent were initially treated with vigabatrin. Other therapies were used more often in known etiology than in unknown etiology as initial treatment (40% versus 6%; P = 0.002). Treatment response at 3 months was not statistically different between unknown etiology and known etiology groups (71% versus 46%; P = 0.08). Overall, initial treatment choice was effective in 35% (23 of 65). Eighty-six percent (37 of 42) who failed the initial medication had subsequent medication trials within 3 months. Conclusions Etiology was strongly associated with initial treatment choice. The variation in treatment choice at our center reflects the limited evidence derived from well-designed clinical trials. |
| Databáze: | OpenAIRE |
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