İnfantil Spazm Sendromunda ACTH ve Vigabatrinin Tedavi Etkinliklerinin Karşılaştırılması

Background: The purpose of this study was to compare treatment efficiencies and side effects of adrenocorticotropic honmone (ACTH) and vigabatrin (VGB) in patients diagnosed with infantile spasms. Material and Methods: Clinical files of 26 pediatric patients diagnosed with infantile spasms hospitalized in Dr. Sami Ulus Child Health and Diseases Research and Training Hospital between July 2000 and September 2002 were analyzed retrospectively. The diagnosis of infantile spasms was based on the presence of typical spasms and hypsarrhythmia or modified hypsarrhythmia in electroencephalogram (EEG). It was determined that ACTH or VGB therapy were initiated to the patients who were diagnosed with infantile spasms. Results: The ACTH group were (15 patients) 61.53% female and 38.47% male; the group receiving vigabatrin were (11 patients), 30.77% male, 69.23% female. Six patients in the ACTH group (46,2%) and 3 patients (23%) in the vigabatrin group had cryptogenic type infantile spasms. Motor/mental development of 2 patients in VGB group were found to be age-appropriate, while the remaining 9 patients and 15 patients receiving ACTH have motor/mental development failure. The mean duration of time until recovery of spasms in ACTHtreated patients and VGB-treated patients were 10.15± 2.4 days and 20.69±3.3 days, respectively. The difference was found to be statistically significant (p<0,05).Conclusions: In this study, clinical files of 26 patients with infantile spasms treated with ACTH and VGB were analyzed retrospectively and efficacy of treatments were compared. Both groups were investigated in terms of age, gender, number of spasms, hospital admission time and accompanying motor/mental retardation. Age at onset of spasms in ACTH group was found to be significantly smaller. Response to treatment in ACTH and VGB groups were found to have a succeses rate as 86.66% and 45.55% respectively