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Posted On : 28 Nov 2009

there was 4 month child with resistant seizures without fever.the patient was not controlled on Phenytoin and phenobarbitone,so was put on valparin.
also since patient was having hypopigmented patch ,mri was done and diagnosed to have TUBEROUS SCLEROSIS with subependymal nodules with calcification.
all baseline investigation done and were normal.
since the patient was controlled on valparin he was discharged on it.
my doubt is should i start ACTH OR Vigabatrin after stopping valparin or should i continue with the same treatment.
waiting for your reply

Expert Answer :

Answer Discussion :

S

sulaiman AbuFaisal

0

I dont know

15 years ago

M

mina safwat

0

use ACTH

15 years ago

K

Krishna Sen

0

Do an EEG.
If non specific cont same treatment and review.

15 years ago

H

H S Raikhy

0

continue the same treatment.

15 years ago

A

Anil Duggal

0

continue the same treatment as patient is seizure free on valprin.

15 years ago

Answer 1

The choice of specific AED for treating seizures in patients with TSC is based on the patient`s seizure type, epilepsy syndrome, other involved organ systems, age of the patient, and AED side effect profiles and formulations available. Vigabatrin is the drug of first choice for children with TSC and infantile spasms. Topiramate, lamotrigine, valproate, and adrenocorticotropic hormone {ACTH}, steroids are also useful. Valproic acid is considered effective first-line AED therapy against infantile spasms {West syndrome} and other seizure types seen in patients with TSC.

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