Reconsideration of Vigabatrin Effect in Infantile Spasms Treatment

Purpose: To investigate the effect of vigabatrin (VGB) as a therapeutic agent for patients with infantile spasms (IS), compare risk factors for treatment response, and review safety of VGB by assessing its side effects. Methods: Among 35 patients admitted to the Department of Pediatric Neurology, Seoul St. Mary s Hospital, College of Medicine, The Catholic University of Korea who received initial monotherapy with VGB under diagnosis of IS, 23 patients who met our inclusion criteria were enrolled and their medical records were retrospectively reviewed. Results: Of these 23 patients, average age at diagnosis was 7.26 ± 4.8 months and average age at spasms was 6.20 ± 3.8 months. Average treatment lag was 1.09 ± 1.8 months. Thirteen patients (56.5%) achieved seizure free status. There was no ophthalmic complication among patients. Remission of hypsarrhythmia at 3 and 6 months after treatment was a good prognostic factor (P=0.026 and P=0.004, respectively). Conclusion: VGB is effective enough to become a first-line drug for children with IS. Better prognosis can be expected in patients with clinical remission of hypsarrhythmia on electroencephalography after treatment initiation using VGB compared to those who do not have such remission. Regular eye examination and follow-up check-up are also needed in parallel with the use of VGB.