Table 5 Results of treatment of infantile spasms on long-term outcome

Ref.ClassnDoseDuration of full dose, wkTotal Rx duration, wkOther RxMean (range) F/UNormal development, no. (%)Normal EEG, no. (%)Seizure-free, no. (%)Deaths, no. (%)
* I Q > 80.
† All symptomatic patients.
p < 0.025 for CIS vs SIS patients.
§ Two deaths secondary to complications of ACTH.
∥ Developmental quotient > 75.
¶ Only reported long-term outcome in B6-responsive cases.
** I Q > 70.
†† Normal or slightly delayed.
Rx = treatment; F/U = follow-up; CIS = cryptogenic infantile spasm; SIS = symptomatic infantile spasm; ACTH = adrenocorticotrophic hormone; PNL = prednisone; VGB = vigabatrin; VPA/HC = combination of sodium valproate and hydrocortisone; B6 = vitamin B6; AED = antiepileptic drug; NS = not stated; Var = variable.
66III6466No50 mo3 (5)*NS30 (47)3 (5)
8CIS44 mo2 (25)
56SIS51 mo1 (2)
28ACTH 20–30 IU66No1 (4)
36PNL 2 mg/kg/d66No2 (6)
23III102VarVarNS>6 y3, 2§
36ACTH 110 IU/m238NS18 (50)14 (39)23 (62)
37ACTH 110 IU/m2, PNL 2 mg/kg/d14–2022–28NS22 (59)15 (41)24 (65)
17PNL 2 mg/kg/d820–32NS2 (12)7 (41)5 (29)
12AEDNSNSNS2 (17)4 (33)3 (25)
67IV109NSNSNS11.5 y26 (24)NS64 (59)0 (0)
14CIS10 (71)NS13 (93)
95SIS16 (17)NS51 (54)
14B6 30–400 mg/dNSNSNS8 (57)NS12 (86)
77ACTH 10 IU2.4NSNS16 (21)NS43 (56)
4VPA 21–42 mg/kg/dNSNSNS0 (0)NS4 (100)
68IV28NSNSNSNS (23–88) mo2 (8)**NS7 (26)
CIS0 (0)NS2 (20)
SIS4 (23)NS4 (23)
ACTH 80 IU0 (0)NS2 (20)2 (18)
VPA 60 mg4 (25)NS4 (25)5 (31)
34IV18VGB 50–150 mg/kg/dYes5.35 y3 (17)††4 (22)13 (72)2 (10)
38IV42VGB 40–150 mg/kg/dYes10–42 mo10 (26) 1 (3) SIS vs 9 (90) CISNS23 (59) 13 (45) SIS vs 10 (100) CIS3 (7)
63IV94VPA 40 mg/kg/d, H/C 15 mg/kg/dNo3.1 y26 (37) 6 (18) SIS vs 20 (74) CIS**NS48 (81) 28 (85) SIS vs 20 (74) CISNS