What is the treatment of infantile spasms?

Infantile spasm is also a refractory epilepsy syndrome, mostly due to brain organic disease or hereditary metabolic disorders caused by. Commonly used antiepileptic drugs almost invalid. Therefore, at present can only be a control on the one hand on the clinical attack, on the other actively seek and clear etiology.

In the area of drug treatment, are the following methods:

① hormone therapy: corticotropin (ACTH) at present are considered to be the most effective, and the more common drugs alone. Dose 25~40 units per day, continuing IM 2-6 week. In control spasm and improving the EEG effect obvious, especially for cases of primary curative effect for you. But the long-term effect is difficult to assess, and have high blood pressure and serum potassium reduces visible.

Is not valid for corticotropin treatment instead, dexamethasone 0.3~?? 0.5? ya g/kg body weight/day or strong pine 2~10mg/kg body weight/day, oral treatment for 2-6 week. If the spasm stopped, EEG and normal, you can press weekly dexamethasone pine?? 0.5mg, or 2.5mg reduction of John pine, until the beginning of one-second, and last for 3 months, and then use a smaller dose maintained for several months.

Corticosteroids reduce volume, you can merge nitrazepam and should pay attention to the prevention and control of infection, sodium and potassium, compensation accordingly.

② sodium valproate: General 15~20mg/kg of the body weight/day starting dose, gradually increasing to 60~70mg/kg body weight/day, up to 100mg/kg individual body weight/day. If non-toxic side effects, effect of large doses is good, but should pay attention to the occurrence of severe liver toxicity.

③ non-urethane, ammonia acid: the two drug clinically often alone or as a secondary drug, beginning as a small dose, after increasing 1 times a week, until they are up effect without significant side effects. Starting dosage for 15mg/kg non-urethane body weight/day maintenance dose is 45mg/kg body weight/day. Ammonia acid dose of 40~100mg/kg body weight/day.

④ Vitamin B6: a 20~50mg/kg body weight/day dose, 3~4 oral dose, from small doses begins, every 3-4 days plus 1 at a later time, serving a total of 2 weeks. At this time if the merge application ACTH or sodium valproate is better, its side effects include loss of appetite, nausea, vomiting, diarrhea and liver function disorders.

⑤ immune globulin: intravenous methods and dose are not currently unified, General 200mg/kg body weight at a time, every other day 1, a total of 3 times, repeat after 3 weeks. Intramuscular injection method of low temperature ethanol-treated human immunoglobulin, per course of treatment 1000~1500mg/k g of body weight, daily 300~600mg, no obvious side effects.

In terms of etiological treatment:

If caused by intracranial space-occupying lesion, after surgery some patients even without taking antiepileptic drugs are no longer attack. Some genetic metabolic disorders by added a large number of b vitamins also can control the attack. And for some unknown cause or causes not relieving infantile spasms, clinically to control seizures. In short, regardless of what kind of situation, and early treatment, attack time of control effect for good, while poor, even the very poor.