@entity739 are a devastating @entity302 of the young @entity1 . The continuing @entity2473 and @entity739 have a deleterious effect on brain maturation and further cognitive development. @entity3317 ( @entity4545 ) or @entity288 have been the gold standard treatment for the last 40 years, but there is little agreement on the best agent to use, or the dosage and duration of the treatment. Despite this empirical approach, corticotropin or @entity288 are effective in controlling @entity2473 and normalising electroencephalograms in about 60% of cases. The major concern with this treatment is the occurrence of frequent and severe adverse effects. The introduction of @entity5305 in the 1990s improved the outcome of @entity739 . @entity5305 shows an efficacy at least equal to that of @entity288 , and even higher in specific groups such as those with @entity2916 . The major advantages of @entity5305 are the ability to initiate treatment at the full dosage. rapid efficacy, suitability for outpatient treatment and particularly good tolerability with only minor adverse effects. Recently, however, the safety of @entity5305 has caused concern since a specific @entity227 has been reported in treated adults. The current problem is determining the risk-benefit ratio of @entity5305 and @entity288 /corticotropin in @entity1 with @entity739 , and to specify the groups where their use could be optimal. Visual field loss is usually asymptomatic and can be detected only by perimetric visual field studies. In @entity1 , especially in the young or disabled, it is difficult if not impossible to detect the @entity227 and it is not yet known if @entity1 are at higher or lower risk for this adverse effect. Until a clear answer about the occurrence of this adverse effect in @entity1 has been established through randomised study, @entity5305 may still be considered first-line therapy in @entity739 . @entity1 who do not achieve a good response to @entity5305 should be switched to corticotropin/corticosteroid therapy. Despite the efficacy of @entity288 and @entity5305 , the use of the conventional antiepileptic drugs, the newly developed antiepileptic drugs and some promising results with ketogenic diet, 25 to 30% of @entity1 with @entity739 continue to have @entity2473 and experience psychomotor regression. These drug-resistant @entity1 could be candidates for surgery.

A risk-benefit assessment of treatments for XXXX .

@entity1 :: ('9606', 'Species') :: ['children', 'patients', 'Children', 'child'] @entity4545 :: ('5443', 'Gene') :: ['adrenocorticotropic hormone'] @entity227 :: ('MESH:D014786', 'Disease') :: ['visual field loss'] @entity5305 :: ('MESH:D020888', 'Chemical') :: ['vigabatrin', 'Vigabatrin'] @entity739 :: ('MESH:D013036', 'Disease') :: ['hypsarrhythmia', 'infantile spasms', 'Infantile spasms'] @entity2916 :: ('MESH:D014402', 'Disease') :: ['tuberous sclerosis'] @entity2473 :: ('MESH:D013035', 'Disease') :: ['spasms'] @entity302 :: ('MESH:D004827', 'Disease') :: ['epileptic encephalopathy'] @entity3317 :: ('MESH:D000324', 'Chemical') :: ['Corticotropin'] @entity288 :: ('MESH:D000305', 'Chemical') :: ['corticosteroids']
@entity739 :: (MESH:D013036,Disease) :: ['infantile spasms']
