2. Treatment Outcome of Infantile Spasms in Neurology Clinic at Wah Cantt
Tahir Mahmood1, Shahzad Haider2 and Sohail Ashraf2
ABSTRACT
Objective: To analyse the treatment outcome of cases with infantile spasms presented in Paediatric Neurology clinic at POF Hospital and Izzat Ali Shah Hospital Wah Cantt.
Study Design: Cross sectional study
Place and Duration of Study: This study was conducted at the Neurology clinic at POF Hospital and Izzat Ali Shah Hospital, Wah Cantt and we consecutively enrolled patients with infantile spasms from a period of 12 months from 1st July 2017 to 30th June 2018.
Materials and Methods: All patients with infantile spasms who presented in Paediatric neurology clinic were analysed. Primary outcome was the improvement in spasms after 6 months of treatment. Treatment was given as Prednisolone, Vigabatrin or combination of both. Data like gender, age of onset of spasm, spasm type, aetiology, developmental delay, head size, pathology, EEG findings, neuroimaging results and outcome in the form of improvement was recorded. Data was analysed in SPSS version 19.
Results: Total 25 patients were studied, 64% of them were male and age of first spasms was < 6 months in 72% of cases. Spasm type was flexor in 56% of the children, 80% of the children had symptomatic type of spasms with development was delayed in 76% of the cases. Hypoxic ischemic encephalopathy was the main pathological cause (40%), Brain atrophy was the commonest finding on neuroimaging and modified hypsarrythmia was found in EEG in 52% of cases. Most of the patients (n=13) were given prednisolone trial and>80%improvement in spasms was seen with all the treatment but combination therapy was mostly effective (60%), though it was not statistically significant. Vigabatrin was effective in patients with Tuberous sclerosis complex.
Conclusion: In our study infantile spasms mostly affected males with symptomatic type and associated with developmental delay. Combination therapy of Prednisolone and Vigabatrin was found to be the most effective treatment. Vigabatrin is an effective treatment in cases of Tuberous sclerosis.
Key Words: Infantile Spasms, Tuberous sclerosis, Prednisolone, Vigabatrin
Citation of articles: Mahmood T, Haider S, Ashraf S. Treatment Outcome of Infantile Spasms in Neurology Clinic at Wah Cantt. Med Forum 2018;29(9):6-9.