Infantile spasms represent a severe epileptic condition typically presenting in infancy,with a varying aetiology.In approximately half of children with infantile spasms,seizures do not improve with initial treatment attempts.We examined the effectiveness of clobazam as adjunctive therapy in patients whose seizures failed to respond to initial regimens of standard treatment for infantile spasms.All patients that received clobazam as adjunctive treatment for infantile spasms were selected for the study. Patients were classified as follows:Complete response in patients with disappearance of convulsions within 2 weeks after administration of clobazam and the patients became spasm-free during weeks 4.In all,70 patients included for the analysis.Clobazam was administered after the usage of 2 (median) antiepileptic drugs (AEDs) that were not effective. Clobazam was added at the mean age of 12 months.After clobazam therapy was initiated,22(31.4%) patients became spasm-free for ≥2 weeks and total 51(72.8%) of patients had decrease more than fifty percent in spasms.Patients with different etiologies and had recevied or not received prior adrenocorticotropic hormone (ACTH)/steroids were similar complete spasm control ratio.Patients who had fewer(one and less) prior exposures to AEDs were more likely to have complete spasm control(47.3%) than the others (25.4%). Adverse effects were minor, and only 4(5.7%) patients experienced.The adverse events observed were sedation, hipotonia. Therefore, clobazam may be an effective and safe alternative treatment option in patients whose seizures do not respond to initial standard treatments for infantile spasms.Further prospective studies focusing on specific groups with good responses,and long-term outcomes of clobazam in infantile spasms are needed.

Betul Kılıc
medipol mega university hospital
Turkey

Esra Ozpinar
medipol mega university hospital
Turkey

Yasemin Topcu
medipol mega university hospital
Turkey

Mehmet Palaz
medipol mega university hospital
Turkey

Kursad Aydin
medipol mega university hospital
Turkey