A 7-month-old infant has been diagnosed with infantile spasms based on clusters of flexor spasms and a hypsarrhythmic EEG. Which of the following is the drug of choice for initial treatment?
- A Adrenocorticotropic hormone (ACTH) ✓
- B Oral prednisolone
- C Carbamazepine
- D Phenytoin
Correct answer: A. Adrenocorticotropic hormone (ACTH)
Explanation
ACTH (intramuscular, given over several weeks) is the established first-line agent for infantile spasms in West syndrome, producing spasm cessation and EEG improvement in a majority of infants. Vigabatrin is the preferred alternative, particularly in tuberous sclerosis where it is especially effective. Carbamazepine and phenytoin are sodium-channel blockers that have no role in spasms and can aggravate some generalized epilepsies.
Reference: Nelson Textbook of Pediatrics, 21st ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.