Steroids or vigabatrin in the treatment of infantile spasms?

In many countries, vigabatrin is now recommended as the first choice of treatment for infantile spasms instead of steroids. The aim of this study was to review the efficacy and side effects of the two drugs, steroids and vigabatrin, by using data from published series. Results suggest that vigabatrin certainly is efficacious in the treatment of the disorder but, on the whole, it does not seem to be any more effective than steroids, especially corticotrophin, even in children with tuberous sclerosis. The possible benefits of vigabatrin do not justify the risks of the possible irreversible visual changes associated with vigabatrin.