15 years of real-world data on the use of vigabatrin in individuals with infantile epileptic spasm syndrome.

Our sequential protocol introducing VGB then adding steroids is an effective alternative to combined VGB-steroids approach in IESS. It avoids steroid related adverse events, as well as those from VGB-steroid combination. According to our data, a period of 7 days seems sufficient to assess VGB response and enables the addition of steroids rapidly if needed. Continuing VGB for 2 years may balance the risk of relapse and treatment-induced adverse events.