Introduction: Vigabatrin (VGB) was specifically synthesized to enhance inhibitory GABAergic transmission by elevating GABA levels via irreversible inhibition of GABA transaminase.

Material And Methods: This study was conducted to determine the efficacy of VGB introduced as monotherapy in 26 children fulfilled the criteria for diagnosis of West syndrome. Duration of follow-up was 24 months.

Results: Following the introduction of VGB, 13 patients became seizure free, a special efficacy in one case of tuberous sclerosis. Relapses of infantile spasms occurred in 8 infants, generalized seizures developed in 4 infants, and partial seizures in 3, of whom 2 were eventually rendered seizure-free by increasing the dose. EEG features and age affecting the response rate. VGB has been well tolerated in children with agitation being the most commonly reported side effects, and one case required discontinuation of therapy.

Conclusions: VGB seems to be an effective an safe antiepileptic drug as primary monotherapy for West syndrome.

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