Herranz J L, Argumosa A
Servicio de Neuropediatría, Hospital Universitario Marquís de Valdecilla, Santander, Spain.
Rev Neurol. 2000;31(6):578-83.
The justification of guidelines for the treatment of children with infantile spasms and West's syndrome.
We review, by means of prospective studies of suitable methodology, the efficacy and side-effects of adrenocorticotropin, sodium valproate, vigabatrin and other drugs used in the treatment of children with West's syndrome.
In view of the information obtained from these studies, we suggest that in children with idiopathic or cryptogenic West's syndrome, treatment should be started with oral prednisone up to a dose of 8 mg/kg/day which should be changed to vigabatrin in the case of inefficacy or side effects. In children with secondary or symptomatic West's syndrome, treatment should be started with vigabatrin, up to a maximum dose of 200 mg/kg/day and if this is ineffective or there are side-effects it should be replaced by prednisone. If neither of these forms of treatment are successful, topiramate (up to 24 mg/kg/day) or valproate (up to 200 mg/kg/day) should be given.
婴儿痉挛症和韦斯特综合征患儿治疗指南的依据。
我们通过采用合适方法的前瞻性研究，回顾了促肾上腺皮质激素、丙戊酸钠、氨己烯酸及其他用于治疗韦斯特综合征患儿的药物的疗效和副作用。
鉴于从这些研究中获得的信息，我们建议，对于特发性或隐源性韦斯特综合征患儿，治疗应从口服泼尼松开始，剂量可达8毫克/千克/天，若治疗无效或出现副作用，则应改用氨己烯酸。对于继发性或症状性韦斯特综合征患儿，治疗应从氨己烯酸开始，最大剂量可达200毫克/千克/天，若无效或出现副作用，则应换用泼尼松。若这两种治疗方式均未成功，则应给予托吡酯（最大剂量24毫克/千克/天）或丙戊酸钠（最大剂量200毫克/千克/天）。
