European Academic Research ISSN 2286-4822
ISSN-L 2286-4822
Impact Factor: 3.4546 (UIF)
DRJI Value : 5.9 (B+)
Article Details :
Article Name :
ACTH versus Vigabatrin as First line Treatment for West Syndrome – A Prospective Study
Author Name :
Kanij Fatema, Md. Mizanur Rahman, Shaheen Akhter, Jannatara Shefa
Publisher :
Bridge Center
Article URL :
Abstract :
West syndrome represents a seizure disorder with unique clinical and electroencephalographic features. The association of spasm and developmental delay or stagnation with definite EEG changes defines West’s syndrome. The study was done to compare the efficacy of corticotropin (Inj ACTH, deep I/M 3 IU/kg/day) and Vigabatrin (50 mg/kg/day), in suppressing clinical spasms in untreated West Syndrome (WS). It was a randomized, prospective study done in Department of Pediatric Neurology and Development, BSMMU in 1 year period. Among sixty patients, group A was randomly given inj ACTH and group B was given oral Vigabatrin as per dose schedule. Among the patients 36(60%) were less than 3 months of age, 20(33%) children were in 3 to 6 month of age and 4 cases (7%) were in 6 to 9 month of age. Perinatal asphyxia was the commonest cause in both groups. In both groups abnormal findings of CT scan and MRI of brain were found in 78.3% cases and hypsarrythmia was the most common EEG finding. 31 patients were treated with ACTH and 29 with vigabatrin (VGB). Cessation of spasms was observed in 12 (41.37%) of the patients randomized to VGB and in 14 (51.61%) of those randomized to ACTH. In ACTH group 32% developed side effects while in VGB group 13 % developed side effects which were statistically significant. (p value < 0.05 ). Conclusion: Our data support that Vigabatrin may be considered a as a first line drug giving emphasis to the response and decreased side effects.
Keywords :
West syndrome, ACTH, Vigabatrin

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