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CC BY 4.0 · Arq Neuropsiquiatr 2023; 81(09): 844-856
DOI: 10.1055/s-0043-1772835
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Brazilian experts' consensus on the treatment of infantile epileptic spasm syndrome in infants

Consenso de especialistas brasileiros sobre o tratamento da síndrome dos espasmos infantis em lactentes
Letícia Pereira de Brito Sampaio 
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo SP, Brazil.
,
Adélia Maria de Miranda Henriques-Souza 
2   Instituto de Medicina Integral Professor Fernando Figueira, Recife PE, Brazil.
3   Hospital da Restauração, Recife, PE, Brazil.
,
Mariana Ribeiro Marcondes da Silveira 
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo SP, Brazil.
,
Lisiane Seguti 
4   Universidade de Brasília, Faculdade de Medicina, Área da Medicina da Criança e do Adolescente, Brasília DF, Brazil.
,
Mara Lúcia Schmitz Ferreira Santos 
5   Hospital Pequeno Príncipe, Departamento de Neurologia Pediátrica, Curitiba PR, Brazil.
,
Maria Augusta Montenegro 
6   University of California San Diego, Rady Children's Hospital, San Diego CA, United States.
,
Sérgio Antoniuk 
7   Universidade Federal do Paraná, Departamento de Pediatria, Curitiba PR, Brazil.
,
Maria Luíza Giraldes de Manreza 
1   Universidade de São Paulo, Faculdade de Medicina, Hospital das Clínicas, São Paulo SP, Brazil.
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Abstract

Background Infantile epileptic spasms syndrome (IESS) is a rare but severe condition affecting children early and is usually secondary to an identifiable brain disorder. It is related to psychomotor deterioration in childhood and epilepsy in adult life. Treatment is challenging as infantile spasms may not respond to most antiseizure medication, and relapse is frequent.

Objective To evaluate the literature regarding treatment of IESS and provide a practical guidance to a healthcare system with limited resources.

Methods An expert committee from the Brazilian Society of Child Neurology reviewed and discussed relevant scientific evidence in the treatment of IESS regarding the drugs available in Brazil.

Results Oral prednisolone and vigabatrin are the most common drugs used as first-line therapy; they are efficient and affordable therapy as both are available in the Brazilian unified health system (SUS, in the Portuguese acronym). Intramuscular adrenocorticotropic hormone (ACTH) presents similar efficacy as oral prednisolone but has a higher cost and is not available in Brazil. Other antiseizure medications such as topiramate, levetiracetam, or benzodiazepines have limited response and are prescribed as adjuvant therapy. If the health service has nutritionists, a ketogenic diet should be implemented for those not responding to hormonal and vigabatrin treatment. Epilepsy surgery is mainly indicated for patients with focal lesions that do not respond to pharmacological therapy.

Conclusion Early treatment of IESS with efficient drugs is feasible in our country. Using standard protocols increases the odds of achieving complete cessation in a shorter time and decreases relapse.

Resumo

Antecedentes A síndrome do espasmo epiléptico infantil (IESS) é uma condição rara, mas grave, que afeta crianças precocemente e geralmente é secundária a um distúrbio cerebral identificável, estando relacionada a deterioração psicomotora na infância e a epilepsia na vida adulta. O tratamento é desafiador, pois os espasmos infantis podem não responder à maioria dos medicamentos anticrises e as recidivas são frequentes.

Objetivo Avaliar a literatura sobre o tratamento de IESS e fornecer uma orientação prática para um sistema de saúde com recursos limitados.

Métodos Um comitê de especialistas da Sociedade Brasileira de Neurologia Infantil revisou e discutiu evidências científicas relevantes no tratamento da IESS em relação aos medicamentos disponíveis no Brasil.

Resultados Prednisolona oral e vigabatrina são os fármacos mais comumente usados como terapia de primeira linha; são eficientes e acessíveis, já que ambos estão disponíveis no sistema único de saúde brasileiro (SUS). O ACTH intramuscular apresenta eficácia semelhante à prednisolona oral, mas tem custo mais elevado e não está disponível no Brasil. Outros medicamentos anticonvulsivos, como topiramato, levetiracetam ou benzodiazepínicos, têm resposta limitada e são prescritos como terapia adjuvante. Se o serviço de saúde tiver nutricionista, deve-se implementar dieta cetogênica para aqueles que não respondem ao tratamento hormonal e vigabatrina. A cirurgia de epilepsia é indicada principalmente para pacientes com lesões focais que não respondem à terapia farmacológica.

Conclusão O tratamento precoce da IESS com fármacos eficazes é factível em nosso meio. O uso de protocolos padronizados aumenta as chances de alcançar a cessação completa em um tempo menor e diminui a recaída.

Keywords

Spasms, Infantile - Treatment - Epilepsy

Palavras-chave

Espasmos Infantis - Tratamento - Epilepsia

Authors' Contributions

LPBS was the project lead, responsible for the manuscript conceptualization, data curation, project administration, and text review and editing. All authors contributed equally on writing the original draft, reviewing and editing the manuscript for submission.


Support

The Brazilian Society of Child Neurology provided financial support for the writing assistance.




Publikationsverlauf

Eingereicht: 23. Januar 2023

Angenommen: 09. Juli 2023

Artikel online veröffentlicht:
04. Oktober 2023

© 2023. Academia Brasileira de Neurologia. This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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  • References

  • 1 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
    CrossrefPubMedGoogle Scholar
  • 2 Shields WD. Infantile spasms: little seizures, BIG consequences. Epilepsy Curr 2006; 6 (03) 63-69
    CrossrefPubMedGoogle Scholar
  • 3 Zuberi SM, Wirrell E, Yozawitz E. et al. ILAE classification and definition of epilepsy syndromes with onset in neonates and infants: Position statement by the ILAE Task Force on Nosology and Definitions. Epilepsia 2022; 63 (06) 1349-1397
    CrossrefPubMedGoogle Scholar
  • 4 Gaily E, Lommi M, Lapatto R, Lehesjoki AE. Incidence and outcome of epilepsy syndromes with onset in the first year of life: A retrospective population-based study. Epilepsia 2016; 57 (10) 1594-1601
    CrossrefPubMedGoogle Scholar
  • 5 Trevathan E, Murphy CC, Yeargin-Allsopp M. The descriptive epidemiology of infantile spasms among Atlanta children. Epilepsia 1999; 40 (06) 748-751
    CrossrefPubMedGoogle Scholar
  • 6 Sidenvall R, Eeg-Olofsson O. Epidemiology of infantile spasms in Sweden. Epilepsia 1995; 36 (06) 572-574
    CrossrefPubMedGoogle Scholar
  • 7 Brna PM, Gordon KE, Dooley JM, Wood EP. The epidemiology of infantile spasms. Can J Neurol Sci 2001; 28 (04) 309-312
    CrossrefPubMedGoogle Scholar
  • 8 Osborne JP, Edwards SW, Dietrich Alber F. et al; participating investigators. The underlying etiology of infantile spasms (West syndrome): Information from the International Collaborative Infantile Spasms Study (ICISS). Epilepsia 2019; 60 (09) 1861-1869
    CrossrefPubMedGoogle Scholar
  • 9 Koo B, Hwang PA, Logan WJ. Infantile spasms: outcome and prognostic factors of cryptogenic and symptomatic groups. Neurology 1993; 43 (11) 2322-2327
    CrossrefPubMedGoogle Scholar
  • 10 Lux AL, Edwards SW, Hancock E. et al. The United Kingdom Infantile Spasms Study comparing vigabatrin with prednisolone or tetracosactide at 14 days: a multicentre, randomised controlled trial. Lancet 2004; 364 (9447) 1773-1778
    CrossrefPubMedGoogle Scholar
  • 11 Wanigasinghe J, Arambepola C, Sri Ranganathan S, Sumanasena S, Muhandiram EC. The efficacy of moderate-to-high dose oral prednisolone versus low-to-moderate dose intramuscular corticotropin for improvement of hypsarrhythmia in West syndrome: a randomized, single-blind, parallel clinical trial. Pediatr Neurol 2014; 51 (01) 24-30
    CrossrefPubMedGoogle Scholar
  • 12 Wanigasinghe J, Arambepola C, Sri Ranganathan S, Sumanasena S, Muhandirum E. Spasm control at 3, 6 and 12 months in west syndrome: randomised, single blind clinical trial on intramuscular long-acting ACTH versus oral prednisolone. Epilepsia 2015; 56: 6
    Google Scholar
  • 13 Wanigasinghe J, Arambepola C, Ranganathan SS, Sumanasena S. Randomized, single-blind, parallel clinical trial on efficacy of oral prednisolone versus intramuscular corticotropin: a 12-month assessment of spasm control in West syndrome. Pediatr Neurol 2017; 76: 14-19
    CrossrefPubMedGoogle Scholar
  • 14 Wanigasinghe J, Arambepola C, Ranganathan SS, Jayasundara K, Weerasinghe A, Wickramarachchi P. Epilepsy outcome at four years in a randomized clinical trial comparing oral prednisolone and intramuscular ACTH in West syndrome. Pediatr Neurol 2021; 119: 22-26
    CrossrefPubMedGoogle Scholar
  • 15 Gowda VK, Narayanaswamy V, Shivappa SK, Benakappa N, Benakappa A. Corticotrophin-ACTH in comparison to prednisolone in West syndrome – A randomized Study. Indian J Pediatr 2019; 86 (02) 165-170
    CrossrefPubMedGoogle Scholar
  • 16 Azam M, Bhatti N, Krishin J. Use of ACTH and prednisolone in infantile spasms: experience from a developing country. Seizure 2005; 14 (08) 552-556
    CrossrefPubMedGoogle Scholar
  • 17 Osborne JP, Hancock E, Edwards S, O'Callaghan FJK. Prednisolone or tetracosactide depot for infantile spasms - A meta-analysis from UKISS and ICISS. Eur J Paediatr Neurol 2015; 19: S17
    CrossrefGoogle Scholar
  • 18 Chang YH, Chen C, Chen SH, Shen YC, Kuo YT. Effectiveness of corticosteroids versus adrenocorticotropic hormone for infantile spasms: a systematic review and meta-analysis. Ann Clin Transl Neurol 2019; 6 (11) 2270-2281
    CrossrefPubMedGoogle Scholar
  • 19 Hussain SA, Shinnar S, Kwong G. et al. Treatment of infantile spasms with very high dose prednisolone before high dose adrenocorticotropic hormone. Epilepsia 2014; 55 (01) 103-107
    CrossrefPubMedGoogle Scholar
  • 20 Chellamuthu P, Sharma S, Jain P, Kaushik JS, Seth A, Aneja S. High dose (4 mg/kg/day) versus usual dose (2 mg/kg/day) oral prednisolone for treatment of infantile spasms: an open-label, randomized controlled trial. Epilepsy Res 2014; 108 (08) 1378-1384
    CrossrefPubMedGoogle Scholar
  • 21 Gonzalez-Giraldo E, Stafstrom CE, Stanfield AC, Kossoff EH. Treating infantile spasms with high-dose oral corticosteroids: a retrospective review of 87 children. Pediatr Neurol 2018; 87: 30-35
    CrossrefPubMedGoogle Scholar
  • 22 Fayyazi A, Eslamian R, Khajeh A, Dehghani M. Comparison of the effect of high and low doses of adrenocorticotropic hormone (ACTH) in the management of infantile spasms. Iran J Child Neurol 2020; 14 (02) 17-25
    PubMedGoogle Scholar
  • 23 Riikonen R, Lähdetie J, Kokki H. ACTH Treatment of infantile spasms: low-moderate- versus high-dose, natural versus synthetic ACTH-a retrospective cohort study. Pediatr Neurol 2020; 111: 46-50
    CrossrefPubMedGoogle Scholar
  • 24 Kapoor D, Sharma S, Garg D. et al. Intravenous methylprednisolone versus oral prednisolone for West syndrome: a randomized open-label trial. Indian J Pediatr 2021; 88 (08) 778-784
    CrossrefPubMedGoogle Scholar
  • 25 Haberlandt E, Weger C, Sigl SB. et al. Adrenocorticotropic hormone versus pulsatile dexamethasone in the treatment of infantile epilepsy syndromes. Pediatr Neurol 2010; 42 (01) 21-27
    CrossrefPubMedGoogle Scholar
  • 26 O'Callaghan FJ, 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 (07) 1359-1364
    CrossrefPubMedGoogle Scholar
  • 27 O'Callaghan FJK, Edwards SW, Alber FD. et al; International Collaborative Infantile Spasms Study (ICISS) investigators. Vigabatrin with hormonal treatment versus hormonal treatment alone (ICISS) for infantile spasms: 18-month outcomes of an open-label, randomised controlled trial. Lancet Child Adolesc Health 2018; 2 (10) 715-725
    CrossrefPubMedGoogle Scholar
  • 28 Farnosova ME, Zharikova TF, Gamirova RG, Sivkova SN. Timing of treatment initiation in West's syndrome. Int J Risk Saf Med 2015; 27 (Suppl. 01) S55-S56
    CrossrefPubMedGoogle Scholar
  • 29 Mytinger JR, Weber A, Heyer GL. The response to ACTH is determined early in the treatment of infantile spasms. Epileptic Disord 2015; 17 (01) 52-57
    CrossrefPubMedGoogle Scholar
  • 30 Maguire MJ, Hemming K, Wild JM, Hutton JL, Marson AG. Prevalence of visual field loss following exposure to vigabatrin therapy: a systematic review. Epilepsia 2010; 51 (12) 2423-2431
    CrossrefPubMedGoogle Scholar
  • 31 Bhalla S, Skjei K. Fulminant vigabatrin toxicity during combination therapy with adrenocorticotropic hormone for infantile spasms: Three cases and review of the literature. Epilepsia 2020; 61 (10) e159-e164
    CrossrefPubMedGoogle Scholar
  • 32 Craft JF, Cardenas AM. Vigabatrin-associated Reversible MRI Abnormalities in an Infant with Tuberous Sclerosis. J Radiol Case Rep 2021; 15 (02) 1-6
    CrossrefPubMedGoogle Scholar
  • 33 Schonstedt V, Stecher X, Venegas V, Silva C. Vigabatrin-induced MRI changes associated with extrapyramidal symptoms in a child with infantile spasms. Neuroradiol J 2015; 28 (05) 515-518
    CrossrefPubMedGoogle Scholar
  • 34 Buoni S, Zannolli R, Strambi M, Fois A. Combined treatment with vigabatrin and topiramate in West syndrome. J Child Neurol 2004; 19 (05) 385-386
    CrossrefPubMedGoogle Scholar
  • 35 Djuric M, Kravljanac R, Tadic B, Mrlješ-Popovic N, Appleton RE. Long-term outcome in children with infantile spasms treated with vigabatrin: a cohort of 180 patients. Epilepsia 2014; 55 (12) 1918-1925
    CrossrefPubMedGoogle Scholar
  • 36 Camposano SE, Major P, Halpern E, Thiele EA. Vigabatrin in the treatment of childhood epilepsy: a retrospective chart review of efficacy and safety profile. Epilepsia 2008; 49 (07) 1186-1191
    CrossrefPubMedGoogle Scholar
  • 37 Overwater IE, Bindels-de Heus K, Rietman AB. et al. Epilepsy in children with tuberous sclerosis complex: Chance of remission and response to antiepileptic drugs. Epilepsia 2015; 56 (08) 1239-1245
    CrossrefPubMedGoogle Scholar
  • 38 Rotta NT, da Silva AR, Ohlweiler L, Riesgo R. [Vigabatrin in the treatment of epilepsy in patients with West syndrome and tuberous sclerosis]. Arq Neuropsiquiatr 2003; 61 (04) 988-990
    Google Scholar
  • 39 Bombardieri R, Pinci M, Moavero R, Cerminara C, Curatolo P. Early control of seizures improves long-term outcome in children with tuberous sclerosis complex. Eur J Paediatr Neurol 2010; 14 (02) 146-149
    CrossrefPubMedGoogle Scholar
  • 40 Henriques-Souza AMM, Ataide Junior L, Laurentino SG. [Treatment of West syndrome with vigabatrin: clinical and electroencephalographic evaluation of 13 patients]. Arq Neuropsiquiatr 2007; 65 (01) 144-149
    Google Scholar
  • 41 Moraes MHP, Montenegro MA, Franzon RC, Avila JO, Guerreiro MM. [Efficacy and tolerability of vigabatrin in West syndrome]. Arq Neuropsiquiatr 2005; 63 (2B): 469-473
    Google Scholar
  • 42 Elterman RD, Shields WD, Bittman RM, Torri SA, Sagar SM, Collins SD. Vigabatrin for the treatment of infantile spasms: final report of a randomized trial. J Child Neurol 2010; 25 (11) 1340-1347
    CrossrefPubMedGoogle Scholar
  • 43 Hussain SA, Schmid E, Peters JM. et al; Tuberous Sclerosis Complex Autism Center of Excellence Network. High vigabatrin dosage is associated with lower risk of infantile spasms relapse among children with tuberous sclerosis complex. Epilepsy Res 2018; 148: 1-7
    CrossrefPubMedGoogle Scholar
  • 44 Lux AL, Edwards SW, Hancock E. et al; United Kingdom Infantile Spasms Study. The United Kingdom Infantile Spasms Study (UKISS) comparing hormone treatment with vigabatrin on developmental and epilepsy outcomes to age 14 months: a multicentre randomised trial. Lancet Neurol 2005; 4 (11) 712-717
    CrossrefPubMedGoogle Scholar
  • 45 Darke K, Edwards SW, Hancock E. et al; trial steering committee on behalf of participating investigators. Developmental and epilepsy outcomes at age 4 years in the UKISS trial comparing hormonal treatments to vigabatrin for infantile spasms: a multi-centre randomised trial. Arch Dis Child 2010; 95 (05) 382-386
    CrossrefPubMedGoogle Scholar
  • 46 Mohamed BP, Scott RC, Desai N, Gutta P, Patil S. Seizure outcome in infantile spasms–a retrospective study. Epilepsia 2011; 52 (04) 746-752
    CrossrefPubMedGoogle Scholar
  • 47 Antoniuk SA, Bruck I, Spessatto A. et al. [West syndrome: clinical and electroencephalographic follow up of 70 patients and response to its treatment with adrenocorticotropic hormone, prednisone, vigabatrin, nitrazepam and valproate]. Arq Neuropsiquiatr 2000; 58 (3A): 683-690
    Google Scholar
  • 48 Ibrahim S, Gulab S, Ishaque S, Saleem T. Clinical profile and treatment of infantile spasms using vigabatrin and ACTH–a developing country perspective. BMC Pediatr 2010; 10: 1-9
    CrossrefPubMedGoogle Scholar
  • 49 O'Callaghan FJ, Edwards SW, Alber FD. et al; participating investigators. 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 (01) 33-42
    CrossrefPubMedGoogle Scholar
  • 50 Yi Z, Wu H, Yu X. et al. High-dose prednisone therapy for infantile spasms and late-onset epileptic spasms in China: The addition of topiramate provides no benefit. Seizure 2019; 71: 174-178
    CrossrefPubMedGoogle Scholar
  • 51 Eliyan Y, Heesch J, Alayari A, Rajaraman RR, Sankar R, Hussain SA. Very-high-dose prednisolone before ACTH for treatment of infantile spasms: evaluation of a standardized protocol. Pediatr Neurol 2019; 99: 16-22
    CrossrefPubMedGoogle Scholar
  • 52 Freeman JM, Kossoff EH, Hartman AL. The ketogenic diet: one decade later. Pediatrics 2007; 119 (03) 535-543
    CrossrefPubMedGoogle Scholar
  • 53 Prezioso G, Carlone G, Zaccara G, Verrotti A. Efficacy of ketogenic diet for infantile spasms: A systematic review. Acta Neurol Scand 2018; 137 (01) 4-11
    CrossrefPubMedGoogle Scholar
  • 54 Dressler A, Benninger F, Trimmel-Schwahofer P. et al. Efficacy and tolerability of the ketogenic diet versus high-dose adrenocorticotropic hormone for infantile spasms: A single-center parallel-cohort randomized controlled trial. Epilepsia 2019; 60 (03) 441-451
    CrossrefPubMedGoogle Scholar
  • 55 Hong AM, Turner Z, Hamdy RF, Kossoff EH. Infantile spasms treated with the ketogenic diet: prospective single-center experience in 104 consecutive infants. Epilepsia 2010; 51 (08) 1403-1407
    CrossrefPubMedGoogle Scholar
  • 56 Kang HC, Lee YJ, Lee JS. et al. Comparison of short- versus long-term ketogenic diet for intractable infantile spasms. Epilepsia 2011; 52 (04) 781-787
    CrossrefPubMedGoogle Scholar
  • 57 Sharma S, Goel S, Kapoor D. et al. Evaluation of the modified atkins diet for the treatment of epileptic spasms refractory to hormonal therapy: a randomized controlled trial. J Child Neurol 2021; 36 (08) 686-691
    CrossrefPubMedGoogle Scholar
  • 58 Zhang J, Chen G, Wang J. et al. Efficacy of the ketogenic diet on ACTH- or corticosteroid-resistant infantile spasm: a multicentre prospective control study. Epileptic Disord 2021; 23 (02) 337-345
    CrossrefPubMedGoogle Scholar
  • 59 Fonseca LF, Oliveira AL. [Infantile spasms: experience in 13 cases]. Arq Neuropsiquiatr 2000; 58 (2B): 512-517
    Google Scholar
  • 60 Fallah R, Salor F, Akhavan Karbasi S, Motaghipisheh H. Randomised clinical efficacy trial of topiramate and nitrazepam in treatment of infantile spasms. Iran J Child Neurol 2014; 8 (01) 12-19
    PubMedGoogle Scholar
  • 61 Zhu X, Chen O, Zhang D. et al. A prospective study on the treatment of infantile spasms with first-line topiramate followed by low-dose ACTH. Epilepsy Res 2011; 93 (2-3): 149-154
    CrossrefPubMedGoogle Scholar
  • 62 Nadig PL, Sahu JK, Suthar R, Saini A, Sankhyan N. Topiramate as an adjunct in the management of West syndrome. Indian J Pediatr 2020; 87 (01) 6-11
    CrossrefPubMedGoogle Scholar
  • 63 Al Ajlouni S, Shorman A, Daoud AS. The efficacy and side effects of topiramate on refractory epilepsy in infants and young children: a multi-center clinical trial. Seizure 2005; 14 (07) 459-463
    CrossrefPubMedGoogle Scholar
  • 64 Mahmoud AA, Rizk TM, Mansy AA, Ali JA, Al-Tannir MA. Ineffectiveness of topiramate and levetiracetam in infantile spasms non-responsive to steroids. Open labeled randomized prospective study. Neurosciences (Riyadh) 2013; 18 (02) 143-146
    Google Scholar
  • 65 Mikati MA, El Banna D, Sinno D, Mroueh S. Response of infantile spasms to levetiracetam. Neurology 2008; 70 (07) 574-575
    CrossrefPubMedGoogle Scholar
  • 66 Gümüş H, Kumandaş S, Per H. Levetiracetam monotherapy in newly diagnosed cryptogenic West syndrome. Pediatr Neurol 2007; 37 (05) 350-353
    CrossrefPubMedGoogle Scholar
  • 67 Dreifuss FE, Santilli N, Langer DH, Sweeney KP, Moline KA, Menander KB. Valproic acid hepatic fatalities: a retrospective review. Neurology 1987; 37 (03) 379-385
    CrossrefPubMedGoogle Scholar
  • 68 Sitarz KS, Elliott HR, Karaman BS, Relton C, Chinnery PF, Horvath R. Valproic acid triggers increased mitochondrial biogenesis in POLG-deficient fibroblasts. Mol Genet Metab 2014; 112 (01) 57-63
    CrossrefPubMedGoogle Scholar
  • 69 Kang HC, Jung DE, Kim KM, Hwang YS, Park SK, Ko TS. Surgical treatment of two patients with infantile spasms in early infancy. Brain Dev 2006; 28 (07) 453-457
    CrossrefPubMedGoogle Scholar
  • 70 Liu SY, An N, Yang MH. et al. Surgical treatment for epilepsy in 17 children with tuberous sclerosis-related West syndrome. Epilepsy Res 2012; 101 (1-2): 36-45
    CrossrefPubMedGoogle Scholar
  • 71 Taussig D, Dorfmüller G, Save J. et al. Hemispherotomy for isolated infantile spasms following perinatal ischemic stroke. Eur J Paediatr Neurol 2015; 19 (05) 597-602
    CrossrefPubMedGoogle Scholar
  • 72 Baba H, Toda K, Ono T, Honda R, Baba S. Surgical and developmental outcomes of corpus callosotomy for West syndrome in patients without MRI lesions. Epilepsia 2018; 59 (12) 2231-2239
    CrossrefPubMedGoogle Scholar
  • 73 Chuang MF, Harnod T, Wang PJ, Chen YH, Hsin YL. Effect of multiple subpial transection on patients with uncontrolled atypical infantile spasms. Epilepsia 2006; 47 (03) 659-660
    CrossrefPubMedGoogle Scholar
  • 74 Wesół-Kucharska D, Rokicki D, Jezela-Stanek A. Epilepsy in Mitochondrial Diseases-Current State of Knowledge on Aetiology and Treatment. Children (Basel) 2021; 8 (07) 532
    PubMedGoogle Scholar
  • 75 Demarest ST, Shellhaas RA, Gaillard WD. et al; Pediatric Epilepsy Research Consortium. The impact of hypsarrhythmia on infantile spasms treatment response: Observational cohort study from the National Infantile Spasms Consortium. Epilepsia 2017; 58 (12) 2098-2103
    CrossrefPubMedGoogle Scholar
  • 76 Sociedade Brasileira de Pediatria. Parasitoses intestinais: diagnóstico e tratamento. 2020 [accessed on 09/12/2022]. Available at: https://www.sbp.com.br/fileadmin/user_upload/22207d-GPA_-_Parasitoses_intestinais_-_diagnostico_e_tratamento.pdf
    PubMedGoogle Scholar
  • 77 Northrup H, Aronow ME, Bebin EM. et al; International Tuberous Sclerosis Complex Consensus Group. Updated International Tuberous Sclerosis Complex Diagnostic Criteria and Surveillance and Management Recommendations. Pediatr Neurol 2021; 123: 50-66
    CrossrefPubMedGoogle Scholar