Treatment of
Infantile Spasms
Immediate action can protect a child’s brain and future
First-Line Treatments
The most effective starting point for stopping infantile spasms.
Adrenocorticotropic Hormone (ACTH)
- Preferred first-line therapy (when tuberous sclerosis is not present)
- Delivered by intramuscular injection
- Low-dose ACTH can be as effective as high-dose, with fewer side effects
Vigabatrin (VGB)
- First choice when infantile spasms are linked to tuberous sclerosis
- FDA-approved and highly effective in these cases
- Requires careful monitoring for possible retinal toxicity, especially with long-term use
Alternative & Adjunctive Options
For cases where first-line therapy isn’t enough.
Prednisone/Prednisolone
Proven to be a very effective therapy when tuberous sclerosis is not present. A lower cost oral alternative to ACTH.
Ketogenic Diet
High-fat, low-carb nutrition plan shown to help when medications fail.
- ~35% of infants may become spasm-free after 1 month
- More children respond by the 3rd month
Other Medications
Zonisamide, topiramate, valproate, pyridoxine, levetiracetam, or combinations. Evidence is limited, but may be considered in treatment-resistant cases.
When Medication Isn’t Enough
Next steps for drug-resistant infantile spasms
Surgical Options
Considered when medications fail and imaging shows a focal brain lesion.
- Options: focal resections or hemispherectomy (when seizures arise from one hemisphere)
- Evidence shows high success rates in well-selected cases
Targeted Interventions
If spasms are caused by a metabolic disorder or structural brain abnormality, treating the root cause (such as removing a lesion) may reduce or eliminate spasms.
Best Practices for Families & Providers
Acting quickly makes the difference.
Seek urgent evaluation
If spasms are suspected, request an EEG immediately and consult a pediatric neurologist.
Track effectiveness
Reassess within 10–14 days. Confirm spasms have stopped and EEG is normal.
Monitor side effects
ACTH/steroids: infection risk, hypertension, sugar imbalance, GI issues, delayed vaccines
Support for families
Provide clear education, resources, and community connections.
Treatment Roadmap
If you suspect infantile spasms, every minute matters—follow these steps to get help fast.
01
Diagnosis & EEG
Confirm spasms urgently.
02
Start First-Line Therapy
ACTH (non-TS) or Vigabatrin (TS cases).
03
Reassess in 10–14 Days
Clinical & EEG evaluation.
04
Try Alternatives
Steroids, ketogenic diet, or additional meds.
05
Surgical Assessment
If drug-resistant with focal lesion.
06
Ongoing Support
Monitor, adjust treatment, support families
Every minute matters.
Early diagnosis, rapid treatment, and continuous monitoring can change the course of
a child’s development.
Take Action. Change a Life.
Your voice, your support, and your awareness can make all the difference for a child facing infantile spasms. Help us spread the word and save more lives—starting today.
