PT  - JOURNAL ARTICLE
AU  - Muhammad T. Alrifai
AU  - Ahmad R. Al-Rumayyan
AU  - Waleed A. Al-Tuwaijri
AU  - Duaa M. Baarmah
AU  - Safiyyah A. Asiri
AU  - Ahmad H. Bali
AU  - Muatassem A. Alsadhan
AU  - Shaden H. Alsugheir
TI  - The response patterns of infantile spasms to treatments in 156 patients
AID  - 10.17712/nsj.2022.1.20210116
DP  - 2022 Jan 01
TA  - Neurosciences Journal
PG  - 40--44
VI  - 27
IP  - 1
4099  - http://nsj.org.sa/content/27/1/40.short
4100  - http://nsj.org.sa/content/27/1/40.full
SO  - Neurosciences (Riyadh)2022 Jan 01; 27
AB  - 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 groupConclusion: 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.