Speaker 1: ACTH or Acthar Gel is one of the medications that's used as a first line treatment for infantile spasms. It's a high dose steroid, given intramuscularly by injection, usually one or two times a day for a short period of time to stop the infantile spasms.
Speaker 2: Remember that infantile spasms are seizures that start out in infancy, somewhere between about four months to about sixteen months. These are sudden, clutching, jerking, almost like myoclonic seizures or repetitive startles. It has a special hallmark on the EEG, what we call a chaotic pattern or a hypsarrhythmic pattern on the EEG.
Speaker 1: That means that the background of the EEG is not normal. This child is most often regressing or developmentally delayed. We need to treat these seizures and control both the seizures and normalize the EEG as quickly as possible. There are two main choices of medication to treat infantile spasms. One of them is ACTH or Acthar Gel and the other is Vigabitron or Sabril.
Speaker 2: Using the Acthar Gel might sound scary. It's a shot, once or twice a day, for about a month. But I have to tell you, it doesn't really have too many bad side effects if you're being monitored and carefully watched.
Speaker 1: What typically happens is the child comes into the hospital, is diagnosed with the infantile spasms, and the parents or the caregiver is instructed on how to inject the medication. They also need to check blood pressure. They need to check for GI upset, they need to check for irritability, and they need to check urine for ketosis or ketones.
They are left on this medication for about a month. Everybody has their own little procedure for doing it. Then they are often switched over to prednisone for a few months.
Speaker 2: Again, we'll put them on a medication to protect their stomach such as a GI protection medication like Zantac. Checking the urine for too much sugar, that they're not developing a diabetes, and the blood pressure.
There's a program that will tell the doctors what exactly to watch for as well as the nurse practitioners, the pediatricians. Everybody will know. These children are monitored every week. They come back to be closely seen and, again, to adjust their medication in case there are any problems.
Agthar Gel for infantile spasms. Safe, effective, and very important to discuss with your doctors and caretakers about what needs to be done.