Infantile Spasms (West Syndrome) — RACP Paediatrics MCQ

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ModerateNeurology & DevelopmentInfantile Spasms (West Syndrome)RACP Paediatrics

A 6-month-old infant presents with clusters of brief flexor spasms occurring upon waking. The spasms last 1–2 seconds and occur in clusters of 10–20. Development has plateaued. What is the first-line treatment?

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Correct answer: C — Vigabatrin or high-dose prednisolone/ACTH

This presentation is consistent with infantile spasms (West syndrome). First-line treatment options are vigabatrin (especially if associated with tuberous sclerosis complex) or hormonal therapy (high-dose prednisolone or ACTH). Urgent treatment is essential to reduce the risk of neurodevelopmental regression. EEG would be expected to show hypsarrhythmia.

Reference: RCH Melbourne – 2024 – Clinical Practice Guidelines: Infantile Spasms