Abstract
Vigabatrin (VGB) is an effective treatment of infantile spasms (IS) that controls spasms of all etiologies in about 50% of patients when used asmonotherapy. In tuberous sclerosis complex, VGB controls spasms in up to 95% of patients and should be used as the drug of choice. HigherVGB doses correlate with shorter times to response and higher response rates. Its most serious side effect is retinal toxicity characterized byirreversible bilateral concentric constriction of the visual fields (BCCVF). Maximum VGB dose, total VGB dose, and duration of VGB treatmentconstitute risk factors for BCCVF. In each particular patient, dose and duration of treatment should be kept at a minimum, while ensuringeffectiveness and preventing relapse. Every effort should be made to evaluate retinal function, even though it may require specializedophthalmological services. The addition of this new US Food and Drug Administration (FDA)-approved drug as an alternative in the treatmentof IS represents a major contribution to an armamentarium that contains only one other treatment.
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