Treatment outcomes of infantile epileptic spasms syndrome at Vietnam National Children Hospital
Main Article Content
Abstract
Infantile epileptic spasms syndrome is one of the most common etiology of early-onset epilepsy in children. Our study describes treatment outcomes of 62 patients with infantile epileptic spasms syndrome treated with a prednisolone-based regimen at the VietNam National Children Hospital from October 2023 to May 2025. After two weeks of treatment, the rate of complete clinical response was 82.3%. At six weeks, the electroclinical response rate was 76.5%. Side effects of prednisolon were observed in 22.6% of patients, most common was Cushing syndrome and infections. No mortality was recorded. These findings indicate that a prednisolone-based regimen is both effective and safe for the treatment of infantile epileptic spasms syndrome.
Article Details
Keywords
Epilepsy, Infantile Epileptic Spasms Syndrome, Prednisolone
References
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4. Kossoff EH, Hartman AL, Rubenstein JE, et al. High-dose oral prednisolone for infantile spasms: An effective and less expensive alternative to ACTH. Epilepsy Behav. 2009; 14(4): 674-676.
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7. Bashiri FA, Hundallah K, Al-Baradie R, et al. Diagnosis and management of infantile epileptic spasms syndrome (IESS) in Gulf Cooperation Council (GCC) countries: Expert consensus statement. Seizure - Eur J Epilepsy. 2024; 117: 174-182.
8. Menderes D, Serdaroğlu E, Hırfanoğlu T, et al. What is the impact of etiology, lead time to treatment, and parental awareness on outcomes in infantile epileptic spasm syndrome? Epilepsy Behav. 2025; 163.
9. O’Callaghan FJK, Lux AL, Darke K, et al. The effect of lead time to treatment and of age of onset on developmental outcome at 4 years in infantile spasms: evidence from the United Kingdom Infantile Spasms Study. Epilepsia. 2011; 52(7): 1359-1364.
10. Widjaja E, Go C, McCoy B, et al. Neurodevelopmental outcome of infantile spasms: A systematic review and meta-analysis. Epilepsy Res. 2015; 109: 155-162.
11. Surana P, Symonds JD, Srivastava P, et al. Infantile spasms: Etiology, lead time and treatment response in a resource limited setting. Epilepsy Behav Rep. 2020; 14: 100397.
12. Dozieres-Puyravel B, Nasser H, Mauvais FX, et al. Real-life data comparing the efficacy of vigabatrin and oral steroids given sequentially or combined for infantile epileptic spasms syndrome. Eur J Paediatr Neurol. 2024; 48: 61-66.
13. Ko A, Youn SE, Chung HJ, et al. Vigabatrin and high-dose prednisolone therapy for patients with West syndrome. Epilepsy Res. 2018; 145: 127-133.
14. O’Callaghan FJK, Edwards SW, Alber FD, et al. Safety and effectiveness of hormonal treatment versus hormonal treatment with vigabatrin for infantile spasms (ICISS): a randomised, multicentre, open-label trial. Lancet Neurol. 2017; 16(1): 33-42.
15. Kuchenbuch M, Lo Barco T, Chemaly N, et al. Fifteen years of real-world data on the use of vigabatrin in individuals with infantile epileptic spasms syndrome. Epilepsia. 2024; 65(2): 430-444.
16. Sharma S, Dhir P, Negi S, et al. Short-Term Effectiveness and Tolerability of Vigabatrin Therapy in Infantile Epileptic Spasms Syndrome. Indian J Pediatr. 2025; 92(4): 398-401.
17. Hahn J, Park G, Kang HC, et al. Optimized Treatment for Infantile Spasms: Vigabatrin versus Prednisolone versus Combination Therapy. J Clin Med. 2019; 8(10): 1591.
18. Boonkrongsak R, Trongkamolchai K, Suwannachote S, et al. Combination Therapy With Vigabatrin and Prednisolone Versus Vigabatrin Alone for Infantile Spasms. Ann Clin Transl Neurol. 2025; 12(5): 1012-1021.
2. Stödberg T, Tomson T, Barbaro M, et al. Epilepsy syndromes, etiologies, and the use of next‐generation sequencing in epilepsy presenting in the first 2 years of life: A population‐based study. Epilepsia. 2020; 61(11): 2486-2499.
3. Symonds JD, Elliott KS, Shetty J, et al. Early childhood epilepsies: epidemiology, classification, aetiology, and socio-economic determinants. Brain. 2021; 144(9): 2879-2891.
4. Kossoff EH, Hartman AL, Rubenstein JE, et al. High-dose oral prednisolone for infantile spasms: An effective and less expensive alternative to ACTH. Epilepsy Behav. 2009; 14(4): 674-676.
5. Lux AL, Osborne JP. A proposal for case definitions and outcome measures in studies of infantile spasms and West syndrome: consensus statement of the West Delphi group. Epilepsia. 2004; 45(11): 1416-1428.
6. Sharma S, Kaushik JS, Srivastava K, et al. Association of Child Neurology (AOCN) - Indian Epilepsy Society (IES) Consensus Guidelines for the Diagnosis and Management of West Syndrome. Indian Pediatr. 2021; 58(1): 54-66.
7. Bashiri FA, Hundallah K, Al-Baradie R, et al. Diagnosis and management of infantile epileptic spasms syndrome (IESS) in Gulf Cooperation Council (GCC) countries: Expert consensus statement. Seizure - Eur J Epilepsy. 2024; 117: 174-182.
8. Menderes D, Serdaroğlu E, Hırfanoğlu T, et al. What is the impact of etiology, lead time to treatment, and parental awareness on outcomes in infantile epileptic spasm syndrome? Epilepsy Behav. 2025; 163.
9. O’Callaghan FJK, Lux AL, Darke K, et al. The effect of lead time to treatment and of age of onset on developmental outcome at 4 years in infantile spasms: evidence from the United Kingdom Infantile Spasms Study. Epilepsia. 2011; 52(7): 1359-1364.
10. Widjaja E, Go C, McCoy B, et al. Neurodevelopmental outcome of infantile spasms: A systematic review and meta-analysis. Epilepsy Res. 2015; 109: 155-162.
11. Surana P, Symonds JD, Srivastava P, et al. Infantile spasms: Etiology, lead time and treatment response in a resource limited setting. Epilepsy Behav Rep. 2020; 14: 100397.
12. Dozieres-Puyravel B, Nasser H, Mauvais FX, et al. Real-life data comparing the efficacy of vigabatrin and oral steroids given sequentially or combined for infantile epileptic spasms syndrome. Eur J Paediatr Neurol. 2024; 48: 61-66.
13. Ko A, Youn SE, Chung HJ, et al. Vigabatrin and high-dose prednisolone therapy for patients with West syndrome. Epilepsy Res. 2018; 145: 127-133.
14. O’Callaghan FJK, Edwards SW, Alber FD, et al. Safety and effectiveness of hormonal treatment versus hormonal treatment with vigabatrin for infantile spasms (ICISS): a randomised, multicentre, open-label trial. Lancet Neurol. 2017; 16(1): 33-42.
15. Kuchenbuch M, Lo Barco T, Chemaly N, et al. Fifteen years of real-world data on the use of vigabatrin in individuals with infantile epileptic spasms syndrome. Epilepsia. 2024; 65(2): 430-444.
16. Sharma S, Dhir P, Negi S, et al. Short-Term Effectiveness and Tolerability of Vigabatrin Therapy in Infantile Epileptic Spasms Syndrome. Indian J Pediatr. 2025; 92(4): 398-401.
17. Hahn J, Park G, Kang HC, et al. Optimized Treatment for Infantile Spasms: Vigabatrin versus Prednisolone versus Combination Therapy. J Clin Med. 2019; 8(10): 1591.
18. Boonkrongsak R, Trongkamolchai K, Suwannachote S, et al. Combination Therapy With Vigabatrin and Prednisolone Versus Vigabatrin Alone for Infantile Spasms. Ann Clin Transl Neurol. 2025; 12(5): 1012-1021.