![]() If an underlying etiology for the spasms is identified, treatment of this etiology is important as well. Response to therapy is followed by evaluating for ongoing clinical spasm events and periodically re-evaluating EEG findings. Infantile spasms often are difficult to treat with some patients needing a repeat course of therapy or a second therapy. Developmental delay and regression is a significant comorbidity of infantile spasms, and appropriate therapies to maximize development should be utilized. Other antiepileptic medications are utilized at times however, these medications are not considered standard first-line treatment. Other steroid regimens sometimes are administered, and additional steroid regimens are being studied. The two primary treatment options in the United States for infantile spasms are corticotropin (ACTH) and vigabatrin. Tuberous sclerosis is one such neurocutaneous disorder that is often associated with infantile spasms. Otherwise, a physical exam is often unremarkable, although a careful skin exam is necessary to screen for possible underlying genetic disorders such as neurocutaneous disorders known to cause infantile spasms. Evidence of developmental delay or regression may be apparent on history and physical exam, although patients who come to medical attention shortly after the onset of spasms may still be developmentally normal. Some children may appear scared or upset by the clusters of spasm activity. Patients return to a baseline mental state within seconds after the spasm. Spasms also are seen more frequently during waking hours than during sleep. These spasms often occur in clusters and clusters often occur during sleep-wake transitions. ![]() Children with infantile spasms experience brief jerking spells of flexion, extension, or combination of flexion-extension of the head, neck, arms, legs, and trunk that usually last a few seconds or less.
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