Vinod Kumar SINGH, Ritu JAIN, Rupa RAJBHADHANDARI, Vivek TYAGI
Archives of Epilepsy - 2026;32(1):1-8
Infantile epileptic spasms syndrome (IESS) is a rare and severe epilepsy syndrome in infants, identified by clusters of spasms, developmental regression, and hypsarrhythmia. Although there are many different therapeutic options including vigabatrin (VGB) and hormonal treatments, the best approach has not reached a consensus. A systematic review was conducted in accordance with PRISMA 2020 guidelines to evaluate the efficacy, safety, and effects of oral suspension VGB on different patient subpopulations. Six studies (34 to 377 participants) from 1999 to 2022 were included. Spasm cessation rates with VGB monotherapy ranged between 11% and 78%, whereas hormonal therapies reached up to 75%. Response rates for combination therapies (VGB with hormones) stood at 71.5%. EEG normalization reached 75% with cosyntropin monotherapy. Adverse event rates ranged from 0% to 86%, with visual field defects occurring in up to 19% of participants. Hormonal therapies were not found to be noticeably better than VGB monotherapy, but combination therapies provided better outcomes while maintaining a balance between efficacy and safety. Tailored treatment strategies are critical, and further research is required.
