Alternative treatment of infantile spasms; Tetracosectide or Vigabatrin? A comparative study

Infantile spasms (IS) is an age specific epileptic syndrome. Due to poor response of IS to conventional antiepileptic drugs, scientists are always on the lookout for newer, more effective drugs to treat the condition. In this study, 50 infants with IS symptoms, aged between 2-24 months, were randomly divided into two equal groups, each treated either with Vigabatrin or ACTH (long acting Tetracosectide); the results for clinical efficacy of medication and drug side effects were compared. After the sixth week of treatment, in the Vigabatrin group, 28% complete remission and 40% reduction in seizure frequencies was seen, while in the Tetracosectide group there were 40.9% complete remission and 45.5% reduction in seizure frequencies, showing no significant difference between the clinical responses found in the two groups (P=0.44). Unfortunately since it is impossible to evaluate visual field constriction, a probable irreversible side effect of Vigabatrin, It''s better to use Tetracosectide for the first line in the treatment of IS.