TREATMENT OF INFANTILE SPASMS WITH HIGH-DOSAGE VITAMIN-B(6)

High-dose vitamin B6 (pyridoxine-HCl, 300 mg/kg/day orally) was introd uced as the initial treatment of recently manifested infantile spasms in 17 children (13 symptomatic cases with identified brain lesion and 4 cryptogenic cases). 5 of 17 children (2 cryptogenic, 2 with severe p re/perinatal brain damage and one with Sturge-Weber syndrome) were cla ssified as responders to high-dose vitamin B6. In all 5 cases the resp onse to vitamin B6 occurred within the first 2 weeks of treatment and within 4 weeks all patients were free of seizures. Two patients develo ped other seizures (partial seizures, etiologically unclear blinking a ttacks), but no relapse of infantile spasms was observed among the fiv e responders to vitamin B6. No serious adverse reactions were noted. S ide effects were mainly gastrointestinal symptoms, which were reversib le after reduction of the dosage. Considering the life-threatening sid e effects of treatment with ACTH/corticosteroids or valproate, a contr olled clinical trial with high-dose vitamin B6 would appear justified to either prove or disprove efficacy.