Individual research recommendation details

Recommendation ID

CG137/3

Question

Infantile spasms: Does treatment response relate to cause in infantile spasms? Does early treatment success in seizure control and resolution of the hypsarrhythmic EEG influence the long-term developmental and cognitive outcomes more than the underlying cause of the spasms?

Any explanatory notes
(if applicable)

The UK Infantile Spasms Study (UKISS) demonstrated 14-day outcome efficacy of steroids over vigabatrin, although this excluded children with tuberous sclerosis. This study provided no specific subgroup analysis based on the cause of the spasms. There was also no analysis on the effect of treatment lag (delay) on the study findings. Further data are available on behavioural outcomes with different treatments at 14 months and 4 years but with no analysis based on cause or treatment lag. Further developmental and cognitive outcomes would be useful, including response by specific cause and by treatment lag.

The research should include:

• prospective randomised design, including subgroup analyses based on both cause and treatment lag; this would require large numbers of patients and would need to be multicentre, possibly involving Western Europe

• EEG outcomes

• developmental status at presentation, and at follow-up

• an attempt to obtain data on pharmaco-resistance.

Source guidance details

Comes from guidance

Epilepsies: diagnosis and management

Number

CG137

Date issued

January 2012

Other details