Real-life data comparing the efficacy of vigabatrin and oral steroids given sequentially or combined for infantile epileptic spasms syndrome

Infantile Epileptic Spasm Syndrome (IESS) is a quite rare epileptic encephalopathy that occurs within the first two years of life, and manifesting with epileptic spams usually in cluster, electroencephalographic anomaly mostly hypsarrhythmia pattern, and developmental arrest or regression. IESS are etiologically classified in symptomatic and cryptogenic. Nowadays there is no general agreement on the treatment of the IESS as hormonal therapy, oral steroid, ketogenic diet and modified Atkins, pyridoxine, anticonvulsants drugs including vigabatrin (VBG), valproate, levetiracetam, topiramate, and benzodiazepines have been proposed to be used individually, sequentially, or in combination ( 1) ). Prompt diagnosis and appropriate treatment in IESS are maintained useful to improve the cognitive course of the disorder. As known, the IESS outcome is related to etiological factors and to precocious treatment ( 2) ).