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World Journal of Pediatrics
Published in: World Journal of Pediatrics 3/2018

01-06-2018 | Original Article

Clinical characteristics of two cohorts of infantile spasms: response to pyridoxine or topiramate monotherapy

Authors: Jiao Xue, Ping Qian, Hui Li, Ye Wu, Hui Xiong, Yue-Hua Zhang, Zhi-Xian Yang

Published in: World Journal of Pediatrics | Issue 3/2018

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Abstract

Background

Infantile spasms (IS) was an epileptic disease with varied treatment widely among clinicians. Here, we aimed to compare and analyze the clinical characteristics of IS response to pyridoxine or topiramate monotherapy (TPM control IS).

Methods

The clinical manifestations, treatment processes and outcomes were analyzed in 11 pyridoxine responsive IS and 17 TPM-control IS.

Results

Of the 11 patients with pyridoxine responsive IS, nine were cryptogenic/idiopathic. Age of seizure onset was 5.36 ± 1.48 months. Spasms were controlled within a week in most of the patients. At the last follow-up, EEG returned to normal in 8. Psychomotor development was normal in 6, mild delay in 3, severe delay in 2. Of the 17 patients with TPM-control IS, 10 were cryptogenic/idiopathic. The age of seizure onset was 5.58 ± 2.09 months. All patients were controlled within a month. At the last follow-up, EEG was normal in 10. Psychomotor development was normal in 8, mild delay in 5, severe delay in 4. Genetic analysis did not show any meaningful results.

Conclusions

The clinical characteristics and disease courses of pyridoxine responsive IS and TPM-control IS were similar, which possibly clued for a same pathogenic mechanism. Pyridoxine should be tried first in all IS patients, even in symptomatic cases. If patients were not responsive to pyridoxine, TPM could be tried.
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Metadata
Title
Clinical characteristics of two cohorts of infantile spasms: response to pyridoxine or topiramate monotherapy
Authors
Jiao Xue
Ping Qian
Hui Li
Ye Wu
Hui Xiong
Yue-Hua Zhang
Zhi-Xian Yang
Publication date
01-06-2018
Publisher
Childrens Hospital, Zhejiang University School of Medicine
Published in
World Journal of Pediatrics / Issue 3/2018
Print ISSN: 1708-8569
Electronic ISSN: 1867-0687
DOI
https://doi.org/10.1007/s12519-018-0127-9

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