Hormonal therapy combined with the antiepileptic drug vigabatrin is more effective in preventing infantile spasms (seen in West Syndrome) than hormonal therapy alone, according to a study published in The Lancet Neurology.This conclusion is based on the results of a randomised clinical trial that was conducted at 102 different hospitals in five different countries, including the UK. The trial compared the efficacy of hormonal therapy and vigabatrin combined with the efficacy of hormonal therapy on its own, in 377 infants with a clinical diagnosis of infantile spasms.The researchers randomly divided the infants into two groups and gave the infants in the first group hormonal therapy with vigabatrin and the infants in the second group hormonal therapy only. They then assessed whether the infants experienced any spasms between day 14 and 42 from the start of the trial.The results showed that 133 of the 186 infants (72%) in the combined therapy group did not experience any spasms between day 14 and 42, compared with 108 out of 191 (57%) in the hormonal therapy only group.Serious side effects requiring hospitalisation occurred in a total of 33 infants (16 on hormonal therapy alone and 17 on hormonal therapy with vigabatrin). The most common serious side effect was infection, which occurred in five infants on hormonal therapy alone and four infants on hormonal therapy with vigabatrin.In a press release, the first author of the study, Dr Finbar O’Callaghan, Consultant Paediatric Neurologist at the Institute of Child Health, University College London, said: “Infantile spasms … is a devastating form of infantile epilepsy that is difficult to treat and is associated with a poor outcome. This study suggests a new treatment approach that will stop spasms faster and in more children than has previously been achieved with existing treatment strategies. It is therefore possible that this will lessen the long-term damage from this devastating epilepsy on developmental outcomes.”Author: Dr Özge ÖzkayaClick here for more news articles about epilepsy in children.