A Guide To Treatment

The reason why these hormones are effective in stopping infantile spasms in many cases is not understood. This treatment is often accompanied by side effects including increased appetite, weight gain, irritability, high blood pressure, high blood sugar and low blood potassium. Contact with some infections (such as chicken pox) may be hazardous during treatment. All of these side effects disappear when treatment stops. Treatment is usually only continued for a few weeks, although sometimes a second course of treatment is necessary. Despite considerable drawbacks, this form of treatment is one of the most successful for infantile spasms.

Benzodiazepenes

Of these drugs nitrazepam (Mogadon) has been most widely used in children with infantile spasms. Clonazepam (Rivotril) and clobazam (Frisium) are sometimes prescribed. These are drugs with an anti-epileptic effect. They may cause excessive sleepiness, altered behaviour and excessive salivation. Many doctors now believe that very long-term use of these drugs is not desirable, as there may be psychological dependence. Although benzodiazepenes may be useful in stopping seizures, it is not uncommon for seizures to restart at a later stage whilst on treatment.

Sodium Valporate (Epilim)

This is one of the most widely prescribed anti-epileptic drugs for children. It is sometimes effective in children with infantile spasms. Side effects which are common include increased appetite and stomach upset. Very occasionally more severe and unpredictable side effects occur, including sudden liver failure (which may begin as a vomiting illness with unexpected drowsiness).

Vigabatrin (Sabril)

This is one of the new anti- epileptic drugs. It appears to be particularly effective in children with infantile spasms, and it may replace steroids as the treatment of first choice. Side effects are few, but some children experience behaviour changes whilst on treatment. It is only available as tablets or in sachet form. As it is a relatively new treatment the long-term effects have not been as fully assessed as with other treatments.

Diets

The most successful dietary treatment for epilepsy is a ketogenic diet, which is high in fat and low in carbohydrates. Although ketogenic diets may help control epileptic seizures in older children who had infantile spasms to begin with, this form of treatment is generally not used for infantile spasms themselves.

Attempts to use diets to treat possible food sensitivities have not been successful in most children. Like any treatment, special diets can have potential side-effects, and in particular there is a risk of causing a deficiency of essential dietary requirements .

Surgery

There has recently been much investigation into brain surgery to treat epilepsy. Surgery may also benefit a few children with infantile spasms which do not respond to other treatments, and where there is a single area of developmental abnormality of the brain. Such possible treatment should not be overlooked, and is one of the reasons to investigate children with infantile spasms (West Syndrome) as thoroughly as possible using brain scans.

Complementary and Alternative Treatments

With a condition which is as difficult to treat successfully as West Syndrome, it is understandable that parents should look to alternative forms of therapy. At present there are no scientifically validated studies to show that such treatments offer any advantage over conventional medical treatments. However, the majority of practitioners of such complimentary medicine are careful and responsible, and in most cases such treatments will not interfere with more orthodox medical treatments. It is important to let the doctors who are treating a child know of all the treatments being given.