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Volume 26 |
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Number 3 |
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Published by : PROFESSIONAL MEDICAL PUBLICATIONS |
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ORIGINAL ARTICLE |
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Volume 26 |
July - September 2010 |
Number 3 |
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Local experience of management of infantile
spasms and its treatment:
A retrospective study of ten casesArif Herekar1
ABSTRACT
Objective: To evaluate and assess the efficacy of ACTH and Vigabatrin in Symptomatic variety of Infantile Spasm in Pakistani patients to document local experience.
Methodology: This is a retrospective study carried out at Neuro Diagnostic Centre, Hamdard University Hospital (Taj Medical Complex), Karachi, from January 2006 to December 2008. Patients registered with Infantile Spasm to the Neuro Diagnostic Centre, Karachi, Pakistan between January 2006 to December 2008 were included in the study. The total number of patients was ten; six male and four female. Age ranged from four months to three and a half years. All patients demonstrated electroencephalographic evidence of hypsarrhythmia and a variety of jerks representing Infantile Spasm.
Results: ACTH was administered in nine out of ten patients but always in combination. Six out of ten patients had Vigabatrin used in tandem with ACTH initially and later Vigabatrin alone (was continued in five of these patients). In one patient Vigabatrin was continued with ACTH and Valproate. ACTH was combined with Valproate in three of the patients while Valproate alone was tried in one patient. All patients on ACTH in whatever combination responded adequately and some of them dramatically becoming seizure-free. The patient on Valproate alone did not respond early and took almost 20 days from start of treatment to become seizure-free.
Conclusion: ACTH was highly effective especially in patients with symptomatic form of Infantile Spasm. Although prednisolone (oral) has not been tried in this study but in affording patients ACTH should remain the first-line treatment for Infantile Spasm especially the symptomatic variety.
KEY WORDS:
Infantile Spasms, Hypsarrhythmia, Epilepsy, Fits, Jerks, Pakistan.Pak J Med Sci July - September 2010 Vol. 26 No. 3 684-687
How to cite this article:
Herekar A. Local experience of management of infantile spasms and its treatment: A retrospective study of ten cases. Pak J Med Sci 2010;26(3):684-687
1. Arif Herekar, M.C.P.S, D.T.M.&H, M.D,
DOW University of Health Sciences,
Karachi, Pakistan.
Correspondence:
Dr. Arif Herekar,
18-B, Main Korangi Road,
D.H.A., Phase-I, Karachi.
E-mail: arifherekar@gmail.com
* Received for Publication: April 7, 2009
* 1st Revision Received: October 2, 2009
* 2nd Revision Received: April 5, 2010
* Final Revision Accepted: April 22, 2010
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