Cargando…

An effective initial polytherapy for children with West syndrome

Adrenocorticotropic hormone is recommended worldwide as an initial therapy for infantile spasms. However, infantile spasms in about 50% of children cannot be fully controlled by adrenocorticotropic hormone monotherapy, seizures recur in 33% of patients who initially respond to adrenocorticotropic ho...

Descripción completa

Detalles Bibliográficos
Autores principales: Jia, Feiyong, Jiang, Huiyi, Du, Lin, Li, Ning, Sun, Ji, Niu, Chunbo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Medknow Publications & Media Pvt Ltd 2013
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145964/
https://www.ncbi.nlm.nih.gov/pubmed/25206459
http://dx.doi.org/10.3969/j.issn.1673-5374.2013.17.011
_version_ 1782332251422326784
author Jia, Feiyong
Jiang, Huiyi
Du, Lin
Li, Ning
Sun, Ji
Niu, Chunbo
author_facet Jia, Feiyong
Jiang, Huiyi
Du, Lin
Li, Ning
Sun, Ji
Niu, Chunbo
author_sort Jia, Feiyong
collection PubMed
description Adrenocorticotropic hormone is recommended worldwide as an initial therapy for infantile spasms. However, infantile spasms in about 50% of children cannot be fully controlled by adrenocorticotropic hormone monotherapy, seizures recur in 33% of patients who initially respond to adrenocorticotropic hormone monotherapy, and side effects are relatively common during adrenocorticotropic hormone treatment. Topiramate, vitamin B(6), and immunoglobulin are effective in some children with infantile spasms. In the present study, we hypothesized that combined therapy with adrenocorticotropic hormone, topiramate, vitamin B(6), and immunoglobulin would effectively treat infantile spasms and have mild adverse effects. Thus, 51 children newly diagnosed with West syndrome including infantile spasms were enrolled and underwent polytherapy with the four drugs. Electroencephalographic hypsarrhythmia was significantly improved in a majority of patients, and these patients were seizure-free, had mild side effects, and low recurrence rates. The overall rates of effective treatment and loss of seizures were significantly higher in cryptogenic children compared with symptomatic children. The mean time to loss of seizures in cryptogenic children was significantly shorter than in symptomatic patients. These findings indicate that initial polytherapy with adrenocorticotropic hormone, topiramate, vitamin B(6), and immunoglobulin effectively improves the prognosis of infantile spasms, and its effects were superior in cryptogenic children to symptomatic children.
format Online
Article
Text
id pubmed-4145964
institution National Center for Biotechnology Information
language English
publishDate 2013
publisher Medknow Publications & Media Pvt Ltd
record_format MEDLINE/PubMed
spelling pubmed-41459642014-09-09 An effective initial polytherapy for children with West syndrome Jia, Feiyong Jiang, Huiyi Du, Lin Li, Ning Sun, Ji Niu, Chunbo Neural Regen Res Neurodegenerative Disease and Neural Regeneration Adrenocorticotropic hormone is recommended worldwide as an initial therapy for infantile spasms. However, infantile spasms in about 50% of children cannot be fully controlled by adrenocorticotropic hormone monotherapy, seizures recur in 33% of patients who initially respond to adrenocorticotropic hormone monotherapy, and side effects are relatively common during adrenocorticotropic hormone treatment. Topiramate, vitamin B(6), and immunoglobulin are effective in some children with infantile spasms. In the present study, we hypothesized that combined therapy with adrenocorticotropic hormone, topiramate, vitamin B(6), and immunoglobulin would effectively treat infantile spasms and have mild adverse effects. Thus, 51 children newly diagnosed with West syndrome including infantile spasms were enrolled and underwent polytherapy with the four drugs. Electroencephalographic hypsarrhythmia was significantly improved in a majority of patients, and these patients were seizure-free, had mild side effects, and low recurrence rates. The overall rates of effective treatment and loss of seizures were significantly higher in cryptogenic children compared with symptomatic children. The mean time to loss of seizures in cryptogenic children was significantly shorter than in symptomatic patients. These findings indicate that initial polytherapy with adrenocorticotropic hormone, topiramate, vitamin B(6), and immunoglobulin effectively improves the prognosis of infantile spasms, and its effects were superior in cryptogenic children to symptomatic children. Medknow Publications & Media Pvt Ltd 2013-06-15 /pmc/articles/PMC4145964/ /pubmed/25206459 http://dx.doi.org/10.3969/j.issn.1673-5374.2013.17.011 Text en Copyright: © Neural Regeneration Research http://creativecommons.org/licenses/by-nc-sa/3.0 This is an open-access article distributed under the terms of the Creative Commons Attribution-Noncommercial-Share Alike 3.0 Unported, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Neurodegenerative Disease and Neural Regeneration
Jia, Feiyong
Jiang, Huiyi
Du, Lin
Li, Ning
Sun, Ji
Niu, Chunbo
An effective initial polytherapy for children with West syndrome
title An effective initial polytherapy for children with West syndrome
title_full An effective initial polytherapy for children with West syndrome
title_fullStr An effective initial polytherapy for children with West syndrome
title_full_unstemmed An effective initial polytherapy for children with West syndrome
title_short An effective initial polytherapy for children with West syndrome
title_sort effective initial polytherapy for children with west syndrome
topic Neurodegenerative Disease and Neural Regeneration
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4145964/
https://www.ncbi.nlm.nih.gov/pubmed/25206459
http://dx.doi.org/10.3969/j.issn.1673-5374.2013.17.011
work_keys_str_mv AT jiafeiyong aneffectiveinitialpolytherapyforchildrenwithwestsyndrome
AT jianghuiyi aneffectiveinitialpolytherapyforchildrenwithwestsyndrome
AT dulin aneffectiveinitialpolytherapyforchildrenwithwestsyndrome
AT lining aneffectiveinitialpolytherapyforchildrenwithwestsyndrome
AT sunji aneffectiveinitialpolytherapyforchildrenwithwestsyndrome
AT niuchunbo aneffectiveinitialpolytherapyforchildrenwithwestsyndrome
AT jiafeiyong effectiveinitialpolytherapyforchildrenwithwestsyndrome
AT jianghuiyi effectiveinitialpolytherapyforchildrenwithwestsyndrome
AT dulin effectiveinitialpolytherapyforchildrenwithwestsyndrome
AT lining effectiveinitialpolytherapyforchildrenwithwestsyndrome
AT sunji effectiveinitialpolytherapyforchildrenwithwestsyndrome
AT niuchunbo effectiveinitialpolytherapyforchildrenwithwestsyndrome