{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,26]],"date-time":"2025-10-26T23:37:27Z","timestamp":1761521847149,"version":"build-2065373602"},"reference-count":27,"publisher":"Georg Thieme Verlag KG","issue":"08","license":[{"start":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T00:00:00Z","timestamp":1755648000000},"content-version":"vor","delay-in-days":19,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arq Neuropsiquiatr"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>West syndrome is an epileptic encephalopathy for which combination therapies with adrenocorticotropic hormone and vigabatrin have emerged as new treatment options.<\/jats:p>\n                  <jats:p>To evaluate the clinical and electroencephalographic remission rates, tolerability, and relapse rates in patients with West syndrome who failed primary treatment and underwent sequential therapy with vigabatrin and adrenocorticotropic hormone.<\/jats:p>\n                  <jats:p>We included 39 patients with West syndrome from 2 specialized centers, aged 2 to 120 months. The patients were treated with intramuscular tetracosactide depot added to vigabatrin and were prospectively followed up for \u2265 1 year. The outcomes were clinical, and electroencephalographic remission rates at 7 and 30 days and 1 year following combined therapy initiation, progression to other epilepsy types, therapy tolerability, and relapse rates were recorded.<\/jats:p>\n                  <jats:p>Of the original sample, 71% of the subjects were boys, and 87% had a known etiology. The clinical and electroencephalographic remission rates were 46.1%, 94.8% (p\u2009=\u20090.001), and 74.1% (p\u2009=\u20090.01) at 7 and 30 days, and 1 year after the initiation of combined therapy, respectively. At the 1-year follow-up, adverse effects were observed in 86.0% and the relapse rate was 21.6%. After a median follow-up of 21 months, 73.6% of the patients developed epilepsy.<\/jats:p>\n                  <jats:p>Combined therapy demonstrated a favorable efficacy profile in achieving clinical and electroencephalographic remission but was associated with significant seizure relapse rates in the medium term. Thus, it represents a feasible option for patients in whom initial treatment has failed.<\/jats:p>","DOI":"10.1055\/s-0045-1811172","type":"journal-article","created":{"date-parts":[[2025,8,20]],"date-time":"2025-08-20T23:41:01Z","timestamp":1755733261000},"page":"001-007","source":"Crossref","is-referenced-by-count":0,"title":["Adrenocorticotropic hormone combined with vigabatrin as a second-line therapy for West syndrome"],"prefix":"10.1055","volume":"83","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1510-6364","authenticated-orcid":false,"given":"Luciana de Paula","family":"Souza","sequence":"additional","affiliation":[{"name":"Secretaria de Estado da Sa\u00fade, Departamento de Sa\u00fade do Paran\u00e1, Curitiba PR, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8229-787X","authenticated-orcid":false,"given":"Danielle Caldas","family":"Bufara","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Hospital de Cl\u00ednicas, Unidade de Neuropediatria, Curitiba PR, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7826-2452","authenticated-orcid":false,"given":"Tallulah Spina","family":"Tensini","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Hospital de Cl\u00ednicas, Departamento de Neurologia, Curitiba PR, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0678-3339","authenticated-orcid":false,"given":"Sergio Antonio","family":"Antoniuk","sequence":"additional","affiliation":[{"name":"Universidade Federal do Paran\u00e1, Hospital de Cl\u00ednicas, Departamento de Pediatria, Curitiba PR, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0207-3671","authenticated-orcid":false,"given":"Gustavo L.","family":"Franklin","sequence":"additional","affiliation":[{"name":"Pontif\u00edcia Universidade Cat\u00f3lica do Paran\u00e1, Escola de Medicina, Departamento de Medicina Interna, Curitiba PR, Brazil."},{"name":"Universidade Federal do Paran\u00e1, Setor de Ci\u00eancias da Sa\u00fade, Departamento de Cl\u00ednica M\u00e9dica, Curitiba PR, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-6669-7312","authenticated-orcid":false,"given":"Ana Chrystina de Souza","family":"Crippa","sequence":"additional","affiliation":[{"name":"Secretaria de Estado da Sa\u00fade, Departamento de Sa\u00fade do Paran\u00e1, Curitiba PR, Brazil."}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"194","published-online":{"date-parts":[[2025,8,20]]},"reference":[{"issue":"06","key":"ref1","doi-asserted-by":"publisher","first-page":"1349","DOI":"10.1111\/epi.17239","article-title":"ILAE classification and definition of epilepsy syndromes with onset in neonates and infants: Position statement by the ILAE Task Force on Nosology and Definitions","volume":"63","author":"S M Zuberi","year":"2022","journal-title":"Epilepsia"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"683","DOI":"10.1590\/s0004-282x2000000400014","article-title":"[West syndrome: clinical and electroencephalographic follow up of 70 patients and response to its treatment with adrenocorticotropic hormone, prednisone, vigabatrin, nitrazepam and valproate]","volume":"58","author":"S A Antoniuk","year":"2000","journal-title":"Arq. 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