Treatment and Outcome in patients with Infantile spasms and Lennox Gastaut Syndrome

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ABSTRACT: AIM: To measure and assess the efficacy of ACTH and Vigabatrin in Infantile Spasm and their Unresponsiveness in Lennox-Gastaut Syndrome in Pakistani Population MATERIALS AND METHODS A study was conducted between year 2006 to 2016 evaluating 120 patients presenting to Neurodiagnostic Centre, Hamdard University Hospital and National Medical Centre, Karachi. Infantile spasms and Salaam Attacks were the basic diagnosis both clinically and electroence phalographically. Age ranges between 1 month to 1.5 years. All patients were administered appropriate doses of Anti Epileptics, ACTH and vitamin supplements RESULTS Amongst 120 patients of Infantile Spasm that we have encountered in last decade about 98 patients (81.6%) who responded well to treatment were below 11 months.3 patients (2.5%) didn't come for the follow up. 20 (16.6%) patients were totally un responsive to treatment, those patients that didn't respond to full therapeutic doses of appropriate Anti Epileptic and ACTH ranged from ages between 12 months to 1.5 years. Even during the treatment, the EEG pattern transformed from classical Hypsarrythmias in some and Burst Suppression in others to classical 1.5 to 2.5 spikes/sec reflecting Lennox Gastaut Syndrome and are best treated under 1-11 months of age. CONCLUSION In view of late arrival of patients, awareness needs to be created so that infantile spasms are picked up at the right time. Patient who have been brought in later stages (>1 year) were unresponsive to treatment and were evolved into Lennox Gastaut Syndrome.

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