Addition of pyridoxine to prednisolone in the treatment of infantile spasms: A pilot, randomized controlled trial

  title={Addition of pyridoxine to prednisolone in the treatment of infantile spasms: A pilot, randomized controlled trial},
  author={Vedavathi Kunnanayaka and Puneet Jain and Suvasini Sharma and Anju Seth and Satinder Aneja},
  journal={Neurology India},
  pages={385 - 390}
Background: West syndrome is a catastrophic epilepsy syndrome characterized by infantile spasms, hypsarrhythmia, and developmental arrest or regression. Aim: The aim of this study was to explore the role of pyridoxine in the management of infantile spasms. Setting and Design: This was a pilot, randomized, open-label trial conducted at a tertiary level hospital from November 2012 to March 2014. Materials and Methods: Children aged 3 months to 3 years presenting with infantile spasms in clusters… 
Effectiveness of ACTH in Patients with Infantile Spasms
Randomized controlled clinical trials with long-term follow-up are needed to compare the effectiveness of ACTH in polytherapy and monotherapy and to investigate Dyskinesias as a potential side effect observed in the study group.
Intravenous Methylprednisolone Versus Oral Prednisolone for West Syndrome: A Randomized Open-Label Trial
It is suggested that OP was better than IVMP in efficacy and sustained remission with fewer adverse effects and weight gain was more common in the OP group.
Treatment of children with infantile spasms: A network meta-analysis.
Both frequentist and Bayesian network rankings for electroclinical remission showed that high dose adrenocorticotropic hormone (ACTH), methylprednisolone, low dose ACTH and magnesium sulfate (MgSO4 ) combination, low dose ACTH, and high dose prednisol one were most likely to be the 'best' interventions, although these were not significantly different from each other.
Hormonal Therapy for Infantile Spasms: A Systematic Review and Meta-Analysis
It was showed that oral corticosteroids could be optional alternatives when ACTH is not applicable, andACTH is more beneficial for patients without TSC, and low-dose ACTH should be recommended due to comparative effectiveness but lower risk of AEs.
West Syndrome Is an Exceptional Presentation of Pyridoxine- and Pyridoxal Phosphate-Dependent Epilepsy: Data From a French Cohort and Review of the Literature
The presentation of PDE- and PLP-dependent epilepsy as de novo West syndrome is so exceptional that it probably does not justify a systematic trial of pyridoxine or PLP, but it is proposed to consider considering a therapeutic trial with these vitamins in West syndrome if spasms are associated with other seizure types or start before the age of 2 months.
A Rare Presentation Characterized by Epileptic Spasms in ALDH7A1, Pyridox(am)ine-5′-Phosphate Oxidase, and PLPBP Deficiency
ES might be a common form of seizures in PNPO deficiency, and EEG presented as hypsarrhythmia or a burst suppression pattern, which could prevent the transformation of the child’s disease from Ohtahara syndrome and infantile spasms to subsequent epileptic encephalopathy or refractory epilepsy.
West syndrome: a comprehensive review
This condition is currently regarded as a spectrum of disorders: the so-called infantile spasm syndrome (ISs), in association with other causal factors, including structural, infectious, metabolic, syndromic, and immunologic events, all acting on a genetic predisposing background.
A Review of the Prevalence, Etiology, Diagnosis, and Management of Pediatric Epilepsies in India
Pediatric seizures are one of the most common neurological manifestations seen in pediatrics. Unravelling the etiology, timely and appropriate investigations followed by suitable therapies are
Association of Child Neurology (AOCN) — Indian Epilepsy Society (IES) Consensus Guidelines for the Diagnosis and Management of West Syndrome
Diagnosis should be based on clinical recognition of spasms and presence of hypsarrhythmia or its variants on electroencephalography, and a magnetic resonance imaging of the brain is the preferred neuroimaging modality.
Management practices for West syndrome in South Asia: A survey study and meta‐analysis
The meta‐analysis supported the preponderance of male gender and structural etiology, a longer LTTT, difficult access to pediatric EEG, nonavailability of ACTH and vigabatrin in some countries, and low effectiveness of hormonal therapy in this region.