What is infantile spasms (West syndrome)

Condition analysis:
Infantile spasms typically consist of a sudden jerk followed by stiffening. Often the arms are flung out as the knees are pulled up and the body bends forward. Each seizure lasts only a second or two but they usually occur close together in a series. Sometimes the spasms are mistaken for colic, but the cramps of colic do not typically occur in a series.

Infantile spasms are most common just after waking up and rarely occur during sleep.  This particularly severe form of epilepsy can lead to poor development and needs to be treated emergently.

Infantile spasms typically begin between 3 and 12 months of age and usually stop by the age of 2 to 4 years.

Instructions:
Treatment for infantile spasms
One of the major drugs used to treat infantile spasms is adrenocorticotropic hormone (ACTH). ACTH is a hormone that is naturally produced in the body. It’s injected into a child’s muscles and has been shown to be very effective in stopping spasms. Because it’s an extremely powerful drug that can cause very dangerous side effects, it’s generally given in low doses for a short amount of time. Side effects may include:
1. high blood pressure
2. bleeding on the brain
3. ulcers
4. infection

Doctors sometimes use an anti-seizure medication called vigabatrin (Sabril) and steroid therapies, like prednisone. Like ACTH, both these drugs have significant side effects.

You and your doctor will have to assess which is the right course of treatment for your baby. ACTH may be slightly more effective than vigabatrin in treating the disorder, but the evidence is weak. There’s also not enough evidence to show whether steroid therapies are as good as ACTH in controlling infantile spasms.

When drug therapies fail to stop the spasms, some doctors may recommend other options. In some cases, surgery to remove the part of the brain causing the seizures may be recommended. A ketogenic diet may also reduce some symptoms. A ketogenic diet is a high-fat, low-carbohydrate eating plan.