Espasmos infantis: experiência em treze casos

Fonseca, Luiz Fernando; Oliveira, Andréa Lara

doi:10.1590/s0004-282x2000000300018

Cited by 1 publication

(1 citation statement)

References 12 publications

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“…A Brazilian case series 59 reported 13 patients using synthetic ACTH associated with valproate, nitrazepam, or clonazepam for maintenance, whereas 55% relapsed and were treated with VGB. 59 …”

Section: Second-line Therapymentioning

confidence: 99%

Brazilian experts' consensus on the treatment of infantile epileptic spasm syndrome in infants

Sampaio,

Henriques-Souza,

Silveira

et al. 2023

Arq Neuropsiquiatr

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Background Infantile epileptic spasms syndrome (IESS) is a rare but severe condition affecting children early and is usually secondary to an identifiable brain disorder. It is related to psychomotor deterioration in childhood and epilepsy in adult life. Treatment is challenging as infantile spasms may not respond to most antiseizure medication, and relapse is frequent. Objective To evaluate the literature regarding treatment of IESS and provide a practical guidance to a healthcare system with limited resources. Methods An expert committee from the Brazilian Society of Child Neurology reviewed and discussed relevant scientific evidence in the treatment of IESS regarding the drugs available in Brazil. Results Oral prednisolone and vigabatrin are the most common drugs used as first-line therapy; they are efficient and affordable therapy as both are available in the Brazilian unified health system (SUS, in the Portuguese acronym). Intramuscular adrenocorticotropic hormone (ACTH) presents similar efficacy as oral prednisolone but has a higher cost and is not available in Brazil. Other antiseizure medications such as topiramate, levetiracetam, or benzodiazepines have limited response and are prescribed as adjuvant therapy. If the health service has nutritionists, a ketogenic diet should be implemented for those not responding to hormonal and vigabatrin treatment. Epilepsy surgery is mainly indicated for patients with focal lesions that do not respond to pharmacological therapy. Conclusion Early treatment of IESS with efficient drugs is feasible in our country. Using standard protocols increases the odds of achieving complete cessation in a shorter time and decreases relapse.

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Section: Second-line Therapymentioning

confidence: 99%