Practice parameter

Medical treatment of infantile spasms: Report of the American Academy of Neurology and the Child Neurology Society

M. T. Mackay, S. K. Weiss, T. Adams-Webber, S. Ashwal, D. Stephens, K. Ballaban-Gill, T. Z. Baram, M. Duchowny, D. Hirtz, J. M. Pellock, W. D. Shields, Shlomo Shinnar, E. Wyllie, O. C. Snead

Research output: Contribution to journalArticle

264 Citations (Scopus)

Abstract

Objective: To determine the current best practice for treatment of infantile spasms in children. Methods: Database searches of MEDLINE from 1966 and EMBASE from 1980 and searches of reference lists of retrieved articles were performed. Inclusion criteria were the documented presence of infantile spasms and hypsarrhythmia. Outcome measures included complete cessation of spasms, resolution of hypsarrhythmia, relapse rate, developmental outcome, and presence or absence of epilepsy or an epileptiform EEG. One hundred fifty-nine articles were selected for detailed review. Recommendations were based on a four-tiered classification scheme. Results: Adrenocorticotropic hormone (ACTH) is probably effective for the short-term treatment of infantile spasms, but there is insufficient evidence to recommend the optimum dosage and duration of treatment. There is insufficient evidence to determine whether oral corticosteroids are effective. Vigabatrin is possibly effective for the short-term treatment of infantile spasm and is possibly also effective for children with tuberous sclerosis. Concerns about retinal toxicity suggest that serial ophthalmologic screening is required in patients on vigabatrin; however, the data are insufficient to make recommendations regarding the frequency or type of screening. There is insufficient evidence to recommend any other treatment of infantile spasms. There is insufficient evidence to conclude that successful treatment of infantile spasms improves the long-term prognosis. Conclusions: ACTH is probably an effective agent in the short-term treatment of infantile spasms. Vigabatrin is possibly effective.

Original languageEnglish (US)
Pages (from-to)1668-1681
Number of pages14
JournalNeurology
Volume62
Issue number10
StatePublished - May 25 2004

Fingerprint

Infantile Spasms
Neurology
Vigabatrin
Therapeutics
Adrenocorticotropic Hormone
Absence Epilepsy
Tuberous Sclerosis
Spasm
Practice Guidelines
MEDLINE
Electroencephalography
Adrenal Cortex Hormones
Outcome Assessment (Health Care)
Databases
Recurrence

ASJC Scopus subject areas

  • Neuroscience(all)

Cite this

Mackay, M. T., Weiss, S. K., Adams-Webber, T., Ashwal, S., Stephens, D., Ballaban-Gill, K., ... Snead, O. C. (2004). Practice parameter: Medical treatment of infantile spasms: Report of the American Academy of Neurology and the Child Neurology Society. Neurology, 62(10), 1668-1681.

Practice parameter : Medical treatment of infantile spasms: Report of the American Academy of Neurology and the Child Neurology Society. / Mackay, M. T.; Weiss, S. K.; Adams-Webber, T.; Ashwal, S.; Stephens, D.; Ballaban-Gill, K.; Baram, T. Z.; Duchowny, M.; Hirtz, D.; Pellock, J. M.; Shields, W. D.; Shinnar, Shlomo; Wyllie, E.; Snead, O. C.

In: Neurology, Vol. 62, No. 10, 25.05.2004, p. 1668-1681.

Research output: Contribution to journalArticle

Mackay, MT, Weiss, SK, Adams-Webber, T, Ashwal, S, Stephens, D, Ballaban-Gill, K, Baram, TZ, Duchowny, M, Hirtz, D, Pellock, JM, Shields, WD, Shinnar, S, Wyllie, E & Snead, OC 2004, 'Practice parameter: Medical treatment of infantile spasms: Report of the American Academy of Neurology and the Child Neurology Society', Neurology, vol. 62, no. 10, pp. 1668-1681.
Mackay MT, Weiss SK, Adams-Webber T, Ashwal S, Stephens D, Ballaban-Gill K et al. Practice parameter: Medical treatment of infantile spasms: Report of the American Academy of Neurology and the Child Neurology Society. Neurology. 2004 May 25;62(10):1668-1681.
Mackay, M. T. ; Weiss, S. K. ; Adams-Webber, T. ; Ashwal, S. ; Stephens, D. ; Ballaban-Gill, K. ; Baram, T. Z. ; Duchowny, M. ; Hirtz, D. ; Pellock, J. M. ; Shields, W. D. ; Shinnar, Shlomo ; Wyllie, E. ; Snead, O. C. / Practice parameter : Medical treatment of infantile spasms: Report of the American Academy of Neurology and the Child Neurology Society. In: Neurology. 2004 ; Vol. 62, No. 10. pp. 1668-1681.
@article{57c73706837d40b199606a29180caf08,
title = "Practice parameter: Medical treatment of infantile spasms: Report of the American Academy of Neurology and the Child Neurology Society",
abstract = "Objective: To determine the current best practice for treatment of infantile spasms in children. Methods: Database searches of MEDLINE from 1966 and EMBASE from 1980 and searches of reference lists of retrieved articles were performed. Inclusion criteria were the documented presence of infantile spasms and hypsarrhythmia. Outcome measures included complete cessation of spasms, resolution of hypsarrhythmia, relapse rate, developmental outcome, and presence or absence of epilepsy or an epileptiform EEG. One hundred fifty-nine articles were selected for detailed review. Recommendations were based on a four-tiered classification scheme. Results: Adrenocorticotropic hormone (ACTH) is probably effective for the short-term treatment of infantile spasms, but there is insufficient evidence to recommend the optimum dosage and duration of treatment. There is insufficient evidence to determine whether oral corticosteroids are effective. Vigabatrin is possibly effective for the short-term treatment of infantile spasm and is possibly also effective for children with tuberous sclerosis. Concerns about retinal toxicity suggest that serial ophthalmologic screening is required in patients on vigabatrin; however, the data are insufficient to make recommendations regarding the frequency or type of screening. There is insufficient evidence to recommend any other treatment of infantile spasms. There is insufficient evidence to conclude that successful treatment of infantile spasms improves the long-term prognosis. Conclusions: ACTH is probably an effective agent in the short-term treatment of infantile spasms. Vigabatrin is possibly effective.",
author = "Mackay, {M. T.} and Weiss, {S. K.} and T. Adams-Webber and S. Ashwal and D. Stephens and K. Ballaban-Gill and Baram, {T. Z.} and M. Duchowny and D. Hirtz and Pellock, {J. M.} and Shields, {W. D.} and Shlomo Shinnar and E. Wyllie and Snead, {O. C.}",
year = "2004",
month = "5",
day = "25",
language = "English (US)",
volume = "62",
pages = "1668--1681",
journal = "Neurology",
issn = "0028-3878",
publisher = "Lippincott Williams and Wilkins",
number = "10",

}

TY - JOUR

T1 - Practice parameter

T2 - Medical treatment of infantile spasms: Report of the American Academy of Neurology and the Child Neurology Society

AU - Mackay, M. T.

AU - Weiss, S. K.

AU - Adams-Webber, T.

AU - Ashwal, S.

AU - Stephens, D.

AU - Ballaban-Gill, K.

AU - Baram, T. Z.

AU - Duchowny, M.

AU - Hirtz, D.

AU - Pellock, J. M.

AU - Shields, W. D.

AU - Shinnar, Shlomo

AU - Wyllie, E.

AU - Snead, O. C.

PY - 2004/5/25

Y1 - 2004/5/25

N2 - Objective: To determine the current best practice for treatment of infantile spasms in children. Methods: Database searches of MEDLINE from 1966 and EMBASE from 1980 and searches of reference lists of retrieved articles were performed. Inclusion criteria were the documented presence of infantile spasms and hypsarrhythmia. Outcome measures included complete cessation of spasms, resolution of hypsarrhythmia, relapse rate, developmental outcome, and presence or absence of epilepsy or an epileptiform EEG. One hundred fifty-nine articles were selected for detailed review. Recommendations were based on a four-tiered classification scheme. Results: Adrenocorticotropic hormone (ACTH) is probably effective for the short-term treatment of infantile spasms, but there is insufficient evidence to recommend the optimum dosage and duration of treatment. There is insufficient evidence to determine whether oral corticosteroids are effective. Vigabatrin is possibly effective for the short-term treatment of infantile spasm and is possibly also effective for children with tuberous sclerosis. Concerns about retinal toxicity suggest that serial ophthalmologic screening is required in patients on vigabatrin; however, the data are insufficient to make recommendations regarding the frequency or type of screening. There is insufficient evidence to recommend any other treatment of infantile spasms. There is insufficient evidence to conclude that successful treatment of infantile spasms improves the long-term prognosis. Conclusions: ACTH is probably an effective agent in the short-term treatment of infantile spasms. Vigabatrin is possibly effective.

AB - Objective: To determine the current best practice for treatment of infantile spasms in children. Methods: Database searches of MEDLINE from 1966 and EMBASE from 1980 and searches of reference lists of retrieved articles were performed. Inclusion criteria were the documented presence of infantile spasms and hypsarrhythmia. Outcome measures included complete cessation of spasms, resolution of hypsarrhythmia, relapse rate, developmental outcome, and presence or absence of epilepsy or an epileptiform EEG. One hundred fifty-nine articles were selected for detailed review. Recommendations were based on a four-tiered classification scheme. Results: Adrenocorticotropic hormone (ACTH) is probably effective for the short-term treatment of infantile spasms, but there is insufficient evidence to recommend the optimum dosage and duration of treatment. There is insufficient evidence to determine whether oral corticosteroids are effective. Vigabatrin is possibly effective for the short-term treatment of infantile spasm and is possibly also effective for children with tuberous sclerosis. Concerns about retinal toxicity suggest that serial ophthalmologic screening is required in patients on vigabatrin; however, the data are insufficient to make recommendations regarding the frequency or type of screening. There is insufficient evidence to recommend any other treatment of infantile spasms. There is insufficient evidence to conclude that successful treatment of infantile spasms improves the long-term prognosis. Conclusions: ACTH is probably an effective agent in the short-term treatment of infantile spasms. Vigabatrin is possibly effective.

UR - http://www.scopus.com/inward/record.url?scp=2442641463&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=2442641463&partnerID=8YFLogxK

M3 - Article

VL - 62

SP - 1668

EP - 1681

JO - Neurology

JF - Neurology

SN - 0028-3878

IS - 10

ER -