Effects of initial polytherapy in newly diagnosed West syndrome

In order to explore the effects of initial polytherapy by combining ACTH followed by prednisone, topiramate, IVIG and vitamin B6 in newly diagnosed West syndrome. 51 children with West syndrome were included in our study. Forty-six patients became spasm-free through polytheray, two children effective and three ineffective. Statistical difference in time to spasm free was found between cryptogenetic patients and symptomatic cases. Of forty-six patients who became spasm free, hypsarrythmia was disappeared in 45 children except one with lissencephaly, normal 24h ambulatory EEG was got in 32 cases with seizure free, spike was found in 15 spasm free children, one case with lissencephaly with seizure free still had hypsarrythmia. Three cases relapsed during the follow-up. Our study demonstrates that initial polytherapy by combining ACTH, topiramate, vitamin B6 and IVIG in West syndrome is a worthwhile choice in clinic.