Treatment of Infantile Spasms with Valproic Acid

  • Taslim S. Soetomenggolo Department of Child Health, Universitas Indonesia Medical School/Dr. Cipto Mangunkusumo Hospital, Jakarta
DOI: https://doi.org/10.14238/pi28.1-2.1988.20-6
Keywords: infantile spasm; EEG; neurological deficit; developmental retardation; cerebral palsy

Abstract

During 2 years (1985- 1986), 12 patients with infantile spasms were treated at the Department of Child Health, Dr. Cipto Mangunkusumo General Hospital, Jakarta.

The diagnosis of infantile spasms was based on the specific clinical manifestation and the specific EEG pattern. -Head CT Scan was done to look for abnormalities of the brain. Eleven (91.6%) of the 12 patients had suffered from neurological deficit before treatment was started. Eleven patients suffered from developmental retardation one patient suffered from cerebral palsy, and 5 patients had microcephaly. In nine (75%) of the 12 patients, the EEG showed hypsarrhythmia, and in 3 (25%) multi focal spikes were found.

All of the 12 patients were treated with the combination of ACTH/dexamethasone and valproic acid. Excellent results were found in 8 (66. 7%) patients, and good in 4 (33.3%). All of the EEG abnormalities disappeared after treatment.

References

1. DRUCKMAN, R.; CHAO, D.: Massive spasms . in infancy and childhood. Epilepsia 4: 61 (1955);
2. GIBBS, E.L.; FLEMING, M.M.; GIBBS, F.A.: Diagnosis and prognosis of hypsarrhythmia and infantile spasms. Pediatrics 33 : 66 (1954).
3. JEAVONS, P.M.; BOWER, B.D.: Infantile spasms; in Vinken, P.J.; Bruyn, G.W., Handbook of clinical neurology; pp. 219-234 (Elsevier, New York 1974).
4. KELLA WAY, P.: Neurologic status of patients with hypsarrhythmia; in Gibbs, F.A., Molecules and Mental Health; pp. 134-149 (Lippincott, Philadelphia 1959).
5. LACY, J.R.; PENRY, J.K.: Infantile spasms; pp. 1-169 (Raven Press, New York 1976).
6. LADWIG, H.A.; VANSLAGER, L.; THOMAS, J.; SCHEINER, G.; MULLER, T.; WAX, J .1.: Infantile spasms with hypsarrhythmia. Nebr. Symp. Motiv. 47: 614 (1962).
7. MARHKAM, C.H.: The treatment of myoclonic seizures of infancy and childhood with LA - I. Pediatrics 34 : 518 (1964).
8. MATSUO, T.: Biochemical aspects of pathophysiology and treatment of intractable epilepsy in children. Brain & Development 5 : 100 (1983).
9. SOREL, L.; DUSAUCY-BAULOYE, A.: A propos de 21 cas d' hypsarrhythmia de Gibbs: Son treatment spectaculaire par 1' ACTH. Acta neurol. psychiat. belg. 58 : 130 (1958).
10. TROJABORG, W.; PLUM, P.: Treatment of "hypsarrhythmia" with ACTH. Acta paediat. scand. 49 : 572 (1960).
11. WATANABE, K.; IWASE, K.; HARA, K.: The evolution of EEG features in infantile spasms: A prospective study. dev. Med. Child Neurol. 15 : 584 (1973).
Published
2019-07-15
How to Cite
1.
Soetomenggolo T. Treatment of Infantile Spasms with Valproic Acid. PI [Internet]. 15Jul.2019 [cited 24Nov.2024];28(1-2):20-. Available from: https://paediatricaindonesiana.org/index.php/paediatrica-indonesiana/article/view/2237
Issue
Vol 28 No 1-2 (1988): January - February 1988
Section
Pediatric Neurology

Copyright (c) 2019 Taslim S. Soetomenggolo

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Received 2019-07-15
Published 2019-07-15