Document Detail


Therapeutic trial of vigabatrin in refractory infantile spasms.
MedLine Citation:
PMID:  1940125     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Infantile spasms usually start during the first year of life and constitute one of the most difficult types of epilepsy to treat. They carry a very poor prognosis for both epilepsy and mental development. Seventy children, including 47 infants, with intractable infantile spasms were entered into an open study with vigabatrin as add-on therapy to the usual anticonvulsant treatment. All were resistant to previous treatments, including corticosteroids (43 patients), carbamazepine, benzodiazepines, and sodium valproate. Two children withdrew from the study because of intolerance to vigabatrin (hypotonia or hypertonia) before evaluation of efficacy could be made. Of the remaining 68 children, 29 (43%) showed complete suppression of spasms. Forty-six children had a greater than 50% reduction in spasms. The best response was observed in those with tuberous sclerosis (12/14 compared with 12/18 with symptomatic infantile spasms of other origin and 22/36 with cryptogenic infantile spasms). Following the initial response to treatment of these patients (n = 68), a long-term response was confirmed in 75% of children with symptomatic infantile spasms and 36% of children with cryptogenic infantile spasms. In eight children, all other anticonvulsant medication could be definitively withdrawn. Tolerability appeared excellent, with 52 of 70 patients reporting no side effects. Somnolence, hypotonia, weight gain, excitation, and insomnia were the most common problems at the beginning of the study and were usually transient. Given the poor prognosis of this type of childhood epilepsy, vigabatrin appears to be a very interesting advance in the management of drug-resistant infantile spasms.
Authors:
C Chiron; O Dulac; D Beaumont; L Palacios; N Pajot; J Mumford
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Journal of child neurology     Volume:  Suppl 2     ISSN:  0883-0738     ISO Abbreviation:  J. Child Neurol.     Publication Date:  1991  
Date Detail:
Created Date:  1991-12-17     Completed Date:  1991-12-17     Revised Date:  2004-11-17    
Medline Journal Info:
Nlm Unique ID:  8606714     Medline TA:  J Child Neurol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  S52-9     Citation Subset:  IM    
Affiliation:
Service de Neuropédiatrie, Hôpital St Vincent de Paul, Paris, France.
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Aminocaproic Acids / adverse effects,  therapeutic use*
Anticonvulsants / adverse effects,  therapeutic use*
Child
Child, Preschool
Dose-Response Relationship, Drug
Drug Therapy, Combination
Electroencephalography / drug effects
Female
Humans
Infant
Male
Recurrence
Single-Blind Method
Spasms, Infantile / drug therapy*
Vigabatrin
Chemical
Reg. No./Substance:
0/Aminocaproic Acids; 0/Anticonvulsants; 60643-86-9/Vigabatrin

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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