|
Author
|
Message
|
neuron03
Credits:
3504
My Scrapbook
|
|
04.10.06 (2 years ago)
#11
|
|
with these options, ans is clearly ACTH. thr wud have been confusion, if one of the choices wud 've been VIGABATRIN.
so far, vigabatrin is doc for infantile spasms assoc with tuberous sclerosis.
the controversy these days is- is vigabatrin superior to acth in non-ts inf spasms?
i'll aprreciate if any1 can provide an evidence based answer to this. (by evidence i mean a good trial published in a reputed indexed journal).
|
|
|
Post Options:
Add to favourite
.
Tell a friend
.
|
|
Back to top
|
|
|
|
zolt
Credits:
9209
My Scrapbook
My Reading List
40 Books
|
|
|
04.12.06 (2 years ago)
#12
|
|
| neuron03 wrote: |
with these options, ans is clearly ACTH. thr wud have been confusion, if one of the choices wud 've been VIGABATRIN.
so far, vigabatrin is doc for infantile spasms assoc with tuberous sclerojavascript:bbstyle(-1)sis.
the controversy these days is- is vigabatrin superior to acth in non-ts inf spasms?
i'll aprreciate if any1 can provide an evidence based answer to this. (by evidence i mean a good trial published in a reputed indexed journal). |
Vigabatrin in infantile spasm:
Vigabatrin -- A 2004 American Academy of Neurology and Child Neurology Society practice parameter concluded that (i) "Vigabatrin is possibly effective for short-term treatment of infantile spasms (Level C, Class III and IV evidence)." (ii) "Vigabatrin is also possibly effective for short-term treatment of infantile spasms in majority of children with tuberous sclerosis (Level C, Class III and IV evidence)." (iii) "Serious concerns about retinal toxicity in adults suggest that serial ophthalmologic screening is required in patients on vigabatrin. However, data are insufficient to make recommendations regarding the frequency or type of screening that would be of value in reducing the prevalence of this complication in children (Level U, Class IV studies)."
Not approved by FDA in US, but available in many countries worldwide. Multiple studies (both open label and double blind) have reported some effectiveness in stopping seizures in infants with West syndrome, especially when caused by tuberous sclerosis.
A 2004 multicenter, randomized, controlled trial in the UK compared hormonal therapy (either oral prednisolone or intramuscular tetracosactide depot, a synthetic analogue of ACTH) to vigabatrin in 107 infants with infantile spasms. More infants assigned hormonal treatments (73%) had no spasms on days 13 and 14 compared to infants assigned vigabatrin (54%, p=0.043). A follow-up study demonstrated that, although hormone treatment controlled spasms better than vigabatrin initially, by age 12-14 months, both groups had similar seizure-free rates.
Currently the first line drugs are:
ACTH, prednisone, vigabatrin, pyridoxine
But for pg entrance acth seems to be the correct answer as of now.
|
|
|
Post Options:
Add to favourite
.
Tell a friend
.
|
|
Back to top
|
|
jayanta
Credits:
38219
My Scrapbook
My Reading List
45 Books
|
|
|
05.21.06 (2 years ago)
#13
|
|
|
IT IS A.C.T,H.
|
|
|
Post Options:
Add to favourite
.
Tell a friend
.
|
|
Back to top
|
|
Mick
Credits:
1340
My Scrapbook
|
|
|
11.07.06 (2 years ago)
#14
|
|
|
ACTH
|
|
|
Post Options:
Add to favourite
.
Tell a friend
.
|
|
Back to top
|
|
sal
Credits:
23054
My Scrapbook
|
|
|
11.07.06 (2 years ago)
#15
|
|
management of infantile spasms
vigabatrin is licensed for first-line treatment of infantile spasms in the UK.
NICE have stated that vigabatrin is recommended as a first-line therapy for the management of infantile spasms (West's syndrome) (1)
when used as monotherapy it abolishes spasms in about 40-50% of newly-diagnosed infants; also it is well-tolerated. However the safety of prolonged treatment with vigabatrin has not been established (especially the risk of visual field impairment)
steroids are an effective alternative to vigabatrin; however severe adverse effects commonly occur
other medical treatments include sodium valproate and nitrazepam
Comments are welcome. Thanks
|
|
|
Post Options:
Add to favourite
.
Tell a friend
.
|
|
Back to top
|
|
skysimba
Credits:
136
My Scrapbook
|
|
|
11.07.06 (2 years ago)
#16
|
|
|
there is no drug of choice.its between ACTH,prednisolone,vigabatrin(in TS)
|
|
|
Post Options:
Add to favourite
.
Tell a friend
.
|
|
Back to top
|
|
scolex
Credits:
174
My Scrapbook
|
|
|
01.29.07 (1 year ago)
#17
|
|
vigabatrin indeed if tuberous sclerosis is indeed proven to be the cause... aetiology proven in only 60%.
vigabatrin is however not yet approved in n america...i live here now, but studied in the netherlands where vigabatrin was used....loss of eyesight is the side effect.
ref: Nelson
|
|
|
Post Options:
Add to favourite
.
Tell a friend
.
|
|
Back to top
|
|
sunu_mbbs
Credits:
133
My Scrapbook
|
|
|
05.29.08 (7 months ago)
#18
|
|
|
ans is acth may be with pred.according to nelson
|
|
|
Post Options:
Add to favourite
.
Tell a friend
.
|
|
Back to top
|
|
sanwar
Credits:
2306
My Scrapbook
|
|
|
07.09.08 (6 months ago)
#19
|
|
Reference for role of vigabatrin in tuberous sclerosis
Eur J Paediatr Neurol. 2007 Nov;11(6):331-6. Epub 2007
|
|
|
Post Options:
Add to favourite
.
Tell a friend
.
|
|
Back to top
|
|
viralbjmc2000
Credits:
1002
My Scrapbook
|
|
|
08.26.08 (4 months ago)
#20
|
|
|
acth
|
|
|
Post Options:
Add to favourite
.
Tell a friend
.
|
|
Back to top
|
|
|
Topic Tags: 
