V!gabatrin in Infantile Spasms: Preliminary Result
ANANNIT VISUDTIBHAN, M.D.*, PONGSAKDI VISUDHIPHAN, M.D.*, SURANG CHIEMCHANYA,M.D.*, SIRIPORN PHUSIRIMONGKOL, B.Ed*
Affiliation : * Division of Pediatric Neurology, Department of Pediatrics, Faculty of Medicine, Ramathibodi Hospital, Mahidol University, Bangkok 10400, Thailand.
Purpose : To evaluate the efficacy of vigabatrin in the treatment of infantile spasms in Thai
children.
Patients &
Method : From March 1996 to May 1998, patients aged under 2 years pre-
senting with infantile spasms at Ramathibodi Hospital were initiated with vigabatrin 35-50 mg/
kg/day in two-divided doses. The dosage was escalated by 25 mglkg weekly until spasms ceased
or the maximum dose of 130 mglkg was reached.
Result: There were 20 patients enrolled. The ages ranged from 3 to 23 months (mean 7.6
months). They were categorized as 4 cryptogenic and 16 symptomatic. Infantile spasms were com-
pletely controlled in 12 patients (60% ). Six patients (30%) had at least 50 per cent reduction of
seizure frequency. There were 2 patients whose seizure frequencies and severity were not altered.
Only one patient whose infantile spasms partially responded to vigabatrin devdoped orofacial
dyskinesis which disappeared after discontinuation of vigabatrin. Five patients had their vision
evaluated which was unremarkable. Based on parental global evaluation, there was an increase in
alertness, cheerfulness and interaction to the environment and stimulation in 8 out of 15 patients
who were still taking vigabatrin and responded to treatment.
Conclusion : Vigabatrin is effective for infantile spasms. A long-term follow-up of these
patients is necessary to evaluate its efficacy and side-effects.
Keywords : Infantile Spasms, Children, Vigabatrin, Efficacy, Side-effects
