PT - JOURNAL ARTICLE AU - Alrifai, Muhammad T. AU - Al-Rumayyan, Ahmad R. AU - Al-Tuwaijri, Waleed A. AU - Baarmah, Duaa M. AU - Asiri, Safiyyah A. AU - Bali, Ahmad H. AU - Alsadhan, Muatassem A. AU - Alsugheir, Shaden H. 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.