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

@article{Kunnanayaka2018AdditionOP,
  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},
  year={2018},
  volume={66},
  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… 
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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.
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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.
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