An effective initial polytherapy for children with West syndrome☆
Adrenocorticotropic hormone is recommended worldwide as an initial therapy for infantile spasms. However, infantile spasms in about 50% of children cannot be fully controlled by adrenocorticotropic hormone monotherapy, seizures recur in 33% of patients who initially respond to adrenocorticotropic ho...
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Medknow Publications & Media Pvt Ltd
2013
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| Online Access: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145964/ |
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pubmed-41459642014-09-09 An effective initial polytherapy for children with West syndrome☆ Jia, Feiyong Jiang, Huiyi Du, Lin Li, Ning Sun, Ji Niu, Chunbo Neurodegenerative Disease and Neural Regeneration Adrenocorticotropic hormone is recommended worldwide as an initial therapy for infantile spasms. However, infantile spasms in about 50% of children cannot be fully controlled by adrenocorticotropic hormone monotherapy, seizures recur in 33% of patients who initially respond to adrenocorticotropic hormone monotherapy, and side effects are relatively common during adrenocorticotropic hormone treatment. Topiramate, vitamin B6, and immunoglobulin are effective in some children with infantile spasms. In the present study, we hypothesized that combined therapy with adrenocorticotropic hormone, topiramate, vitamin B6, and immunoglobulin would effectively treat infantile spasms and have mild adverse effects. Thus, 51 children newly diagnosed with West syndrome including infantile spasms were enrolled and underwent polytherapy with the four drugs. Electroencephalographic hypsarrhythmia was significantly improved in a majority of patients, and these patients were seizure-free, had mild side effects, and low recurrence rates. The overall rates of effective treatment and loss of seizures were significantly higher in cryptogenic children compared with symptomatic children. The mean time to loss of seizures in cryptogenic children was significantly shorter than in symptomatic patients. These findings indicate that initial polytherapy with adrenocorticotropic hormone, topiramate, vitamin B6, and immunoglobulin effectively improves the prognosis of infantile spasms, and its effects were superior in cryptogenic children to symptomatic children. Medknow Publications & Media Pvt Ltd 2013-06-15 /pmc/articles/PMC4145964/ /pubmed/25206459 http://dx.doi.org/10.3969/j.issn.1673-5374.2013.17.011 Text en Copyright: © Neural Regeneration Research http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. |
| repository_type |
Open Access Journal |
| institution_category |
Foreign Institution |
| institution |
US National Center for Biotechnology Information |
| building |
NCBI PubMed |
| collection |
Online Access |
| language |
English |
| format |
Online |
| author |
Jia, Feiyong Jiang, Huiyi Du, Lin Li, Ning Sun, Ji Niu, Chunbo |
| spellingShingle |
Jia, Feiyong Jiang, Huiyi Du, Lin Li, Ning Sun, Ji Niu, Chunbo An effective initial polytherapy for children with West syndrome☆ |
| author_facet |
Jia, Feiyong Jiang, Huiyi Du, Lin Li, Ning Sun, Ji Niu, Chunbo |
| author_sort |
Jia, Feiyong |
| title |
An effective initial polytherapy for children with West syndrome☆ |
| title_short |
An effective initial polytherapy for children with West syndrome☆ |
| title_full |
An effective initial polytherapy for children with West syndrome☆ |
| title_fullStr |
An effective initial polytherapy for children with West syndrome☆ |
| title_full_unstemmed |
An effective initial polytherapy for children with West syndrome☆ |
| title_sort |
effective initial polytherapy for children with west syndrome☆ |
| description |
Adrenocorticotropic hormone is recommended worldwide as an initial therapy for infantile spasms. However, infantile spasms in about 50% of children cannot be fully controlled by adrenocorticotropic hormone monotherapy, seizures recur in 33% of patients who initially respond to adrenocorticotropic hormone monotherapy, and side effects are relatively common during adrenocorticotropic hormone treatment. Topiramate, vitamin B6, and immunoglobulin are effective in some children with infantile spasms. In the present study, we hypothesized that combined therapy with adrenocorticotropic hormone, topiramate, vitamin B6, and immunoglobulin would effectively treat infantile spasms and have mild adverse effects. Thus, 51 children newly diagnosed with West syndrome including infantile spasms were enrolled and underwent polytherapy with the four drugs. Electroencephalographic hypsarrhythmia was significantly improved in a majority of patients, and these patients were seizure-free, had mild side effects, and low recurrence rates. The overall rates of effective treatment and loss of seizures were significantly higher in cryptogenic children compared with symptomatic children. The mean time to loss of seizures in cryptogenic children was significantly shorter than in symptomatic patients. These findings indicate that initial polytherapy with adrenocorticotropic hormone, topiramate, vitamin B6, and immunoglobulin effectively improves the prognosis of infantile spasms, and its effects were superior in cryptogenic children to symptomatic children. |
| publisher |
Medknow Publications & Media Pvt Ltd |
| publishDate |
2013 |
| url |
https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145964/ |
| _version_ |
1613128148916895744 |