Treatment of Infantile Spasms: Emerging Insights From Clinical and Basic Science Perspectives

Carl E. Stafstrom, University of Wisconsin - Madison
Barry G.W. Arnason, University of Chicago
Tallie Z. Baram, University of California - Irvine
Anna Catania, Fondazione Ca’ Granda-Ospedale Maggiore Policlinico
Miguel A. Cortez, University of Toronto
Tracy A. Glauser, University of Cincinnati
Michael R. Pranzatelli, Southern Illinois University School of Medicine
Raili Riikonen, University of Kuopio
Michael A. Rogawski, University of California - Davis
Shlomo Shinnar, Albert Einstein College of Medicine
John W. Swann, Baylor College of Medicine

Abstract

Infantile spasms is an epileptic encephalopathy of early infancy with specific clinical and electroencephalographic (EEG) features, limited treatment options, and a poor prognosis. Efforts to develop improved treatment options have been hindered by the lack of experimental models in which to test prospective therapies. The neuropeptide adrenocorticotropic hormone (ACTH) is effective in many cases of infantile spasms, although its mechanism(s) of action is unknown. This review describes the emerging candidate mechanisms that can underlie the therapeutic effects of ACTH in infantile spasms. These mechanisms can ultimately help to improve understanding and treatment of the disease. An overview of current treatments of infantile spasms, novel conceptual and experimental approaches to infantile spasms treatment, and a perspective on remaining clinical challenges and current research questions are presented here. This summary derives from a meeting of specialists in infantile spasms clinical care and research held in New York City on June 14, 2010.