Abstracts

Rationale: Early cessation of the spasms was attained significantly more often with hormonal therapy than with vigabatrin in the UKISS study as published in Epilepsia 2010;51(10); 2215-6. Recently, high dose oral prendnisolone has been shown to be an effective treatment options for epileptic spasms as published in Epilepsy Research 2014;108(8);1378-1384. This study aimed to investigate short-term response to intravenous methylprednisolone pulse therapy for treatment of infantile spasms. Methods: Patients with newly diagnosed infantile spasms were included from 2014 to 2016 at Asan medical center and Sanggye Paik hospital. The diagnosis of infantile spasms was made by the characteristic spasms and hypsarrhythmia on the electroencephalography. All included patients were treated by intravenous infusions of 30mg/kg/day methylprednisolone for 3 days and the tapering doses of oral prednisolone were administered for 2-6 weeks for the treatment of infantile spasms. Response to intravenous methylprednisolone pulse therapy was evaluated by parental reports and repeat EEG within two weeks. Results: Seventeen patients were included in this study. The mean ages at onset of spasms is 6.8 months (range, 2 to 11 months) and mean follow-up period after methylprednisolone pulse therapy is 6.2 months (range, 3 to 10 months). Etiological factors were hypoxic ischemic encephalopathy (N=11), chromosomal anomaly (N=2), polymicrogyria (N=2) and unknown (N=2). Associated developmental delay was recognized in 16 of 17 prior to treatment. Eleven (11/17, 64%) among seventeen participants showed completely spasms free with improvement on EEG within two weeks. However, six of 11 responders (54.5 %) remained spasms free after the discontinuation of oral steroids and one responder experienced a relapse several months after the initial response. Adverse effects including irritability or infection were observed in four of them but tolerable in all. Conclusions: The ideal treatment for infantile spasms is unclear and many studies advocate the efficacy of hormonal treatment. In our study, short-term methylprednisolone pulse therapy for treatment of infantile spasms showed rapid EEG improvement and cessation of spasms without serious side effects. Further studies are needed to prove longer-term effects of spasms control and their developments. Funding: I did not receive any funding in support of this abstract.