December 2012. Volume 8. Number 4

Adrenocorticotropic hormone is the treatment of choice for children with infantile spasms

 
 
 
 
 
 
 
 
 
 
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AVC | Critically appraised articles

Go CY, Mackay MT, Weiss SK, Stephens D, Adams-Webber T, Ashwal S, et al. Evidence-based guideline update: Medical treatment of infantile spasms. Report of the guideline development subcommittee of the American Academy of Neurology and the Practice Commettee of the Child Neurology Society. Neurology. 2012;78:1974-80
Reviewers: Ramos Lizana J1, Rivas Fernández MÁ2.
1Unidad de Neurología Pediátrica. Hospital Torrecárdenas. Almería. España.
2Hospital General de Cataluña, Barcelona. Sant Cugat del Vallés. Barcelona. España.
Correspondence: Julio Ramos Lizana. Email: jramoslizana@telefonica.net
Reception date: 22/10/2012
Acceptance date: 12/11/2012
Publication date: 28/11/2012

Abstract

Authors' conclusions: adrenocorticotropic hormone (ACTH) is more effective than vigabatrin (VGB) for the treatment of infantile spasms, low-dose ACTH is probably as effective as high-dose ACTH, data are insufficient to establish or discard the equivalence of other corticoids and ACTH and for making recommendations about other treatments. In the long term, hormonal therapy obtains better outcomes in respect to psychomotor development.

Reviewers' commentary: this is a systematic review with an acceptable quality level. Although the available evidence about the treatment of infantile spasms is in general of low or medium quality, until better studies become available, it seems reasonable to accept that the treatment of choice for infantile spasms, not related to tuberous sclerosis, is low-dose ACTH.

How to cite this article

Ramos Lizana J, Rivas Fernández MA. En niños con espasmos infantiles, el tratamiento de elección es la hormona adrenocorticotropa. Evid Pediatr. 2012;8:81.

AVC | Critically appraised articles

Go CY, Mackay MT, Weiss SK, Stephens D, Adams-Webber T, Ashwal S, et al. Evidence-based guideline update: Medical treatment of infantile spasms. Report of the guideline development subcommittee of the American Academy of Neurology and the Practice Commettee of the Child Neurology Society. Neurology. 2012;78:1974-80
Reviewers: Ramos Lizana J1, Rivas Fernández MÁ2.
1Unidad de Neurología Pediátrica. Hospital Torrecárdenas. Almería. España.
2Hospital General de Cataluña, Barcelona. Sant Cugat del Vallés. Barcelona. España.
Correspondence: Julio Ramos Lizana. Email: jramoslizana@telefonica.net
Reception date: 22/10/2012
Acceptance date: 12/11/2012
Publication date: 28/11/2012

How to cite this article

Ramos Lizana J, Rivas Fernández MA. En niños con espasmos infantiles, el tratamiento de elección es la hormona adrenocorticotropa. Evid Pediatr. 2012;8:81.

References

  1. 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 Americal Academy of Neurology and the Child Neurology Society. Neurology. 2004;62:1668-81.
  2. Hancock EC, Osborne JP, Edwards SW. Treatment of infantile spasms. Cochrane Database Syst Rev. 2008;(4):CD001770.
  3. Lux AL, Edwards SW, Hancock E, Johnson AL, Kennedy CR, Newton RW, et al. The United Kingdom Infantile Spasm Study comparing vigabatrin with prednisolone or tetracosactide at 14 days: a multicentre, randomised, controlled trial. Lancet. 2004;364:1773-8.
  4. Lux AL, Edwards SW, Hancock E, Johnson AL, Kennedy CR, Newton RW, et al. The United Kingdom Infantile Spasm Study comparing hormone treatment with vigabatrin on developmental and epilepsy outcomes to age 14 months: a multicentre randomised trial. Lancet Neurol. 2005;4(11):712-7.
28/11/2012
Infantile spasms are a severe type of infantile epilepsy. A variety of treatments can be utilized. This review suggest that de treatment of choice is low-dose adrenocorticotropic hormone.

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