| Article Details : |
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| | | Article Name : | | | ACTH versus Vigabatrin as First line Treatment for
West Syndrome – A Prospective Study | | Author Name : | | | Dr KANIJ FATEMA1, Prof. Md. MIZANUR RAHMAN, Prof SHAHEEN AKHTER, Dr. 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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