Why does it feel like my baby is having spasms?

Currently over 30 national and international organizations strong, ISAN hosts Infantile Spasms Awareness Week every December and created the STOP IS mnemonic—seen by 195 million!

Visit Infantilespasms.org to learn more.

In 2015, CNF partnered with the Tuberous Sclerosis Alliance (TS Alliance) to lead a multi-year IS awareness and education initiative. IS efforts are showcased during ISAW. In 2016, CNF convened two forums that brought together epilepsy advocates and leaders from provider member societies. The group discussed a comprehensive strategy to raise IS awareness. Today, this group has grown into a collaborative network of 30 national and international entities focused on raising awareness for infantile spasms.

Questions about ISAN? Want your organization/company to get involved? Visit Infantilespasms.org.

Infantile Spasms Awareness

Infantile Spasms (IS) are a medical emergency. Infantile spasms are a rare, but very serious type of seizure. Infantile spasms are caused by a condition in a baby’s brain and include repetitive, but often subtle movements—such as jerking of the mid-section, dropping of the head, raising of the arms or wide-eyed blinks. IS can be misdiagnosed as colic, reflux, or a startle reflex.

Together We Can STOP IS!

Although awareness efforts are year-round, Infantile Spasms Awareness Week (ISAW) is held annually on December 1-7. During ISAW 2017, the Infantile Spasms Action Network (ISAN) introduced the STOP Infantile Spasms mnemonic. With the mnemonic as the centerpiece for 2017 awareness, we reached over 195 million due to the collective efforts of ISAN.

This helpful mnemonic tool – an easily remembered acronym—is STOP Infantile Spasms:

See the signs: Clusters of sudden, repeated, uncontrolled movements like head bobs or body crunching.

Take a video: Record the symptoms and talk to your doctor immediately.

Obtain diagnosis: Confirm an irregular brain wave pattern with an EEG test.

Prioritize treatment: End spasms to minimize developmental delays

Know the signs to ‘STOP’ Infantile Spasms. Identifying spasms is critical for parents, caregivers and providers.

Learn More about IS!

Infantile Spasms (IS) are a medical emergency. Infantile spasms are a rare, but very serious type of seizure.

Infantile spasms (IS) are seizures, usually occurring in children under age one, which are often overlooked. IS can cause catastrophic, permanent damage to a child’s developing brain.

• Infantile spasms are caused by a condition in a baby’s brain and include repetitive, but often subtle movements—such as jerking of the mid-section, dropping of the head, raising of the arms or wide-eyed blinks. IS can be misdiagnosed as colic, reflux, or a startle reflex.
• While infantile spasms appear as subtle movements – not as outwardly visible as grand mal or “convulsion” seizures – they are still a dangerous form of epilepsy.
• Often, infantile spasms occur in quick succession—sometimes dozens at a time. A baby can have more than 100 seizures in one day!
• Worldwide, it is estimated that a baby is diagnosed with infantile spasms every 12 minutes.
• Infantile spasms occur in up to 35 percent of children with tuberous sclerosis complex (TSC), a genetic disorder that causes tumors to form in various organs and the leading genetic cause of both epilepsy and autism.

Know the signs to ‘STOP’ Infantile Spasms. Urgent identification is critical for parents, caregivers and providers.

Prompt diagnosis and treatment are critical, but this is challenging because infantile spasms can be mistaken for normal baby movements or other disorders that don’t demand urgency.

• Pediatricians, emergency care physicians, and family practitioners are often the first to see a baby with infantile spasms (IS). Awareness of IS symptoms and prompt action are critical.
• Parents and caregivers often report that their concerns are not heard by their providers and infantile spasms are overlooked, but they should feel empowered to pursue more investigation.
• The earlier a child is diagnosed, the greater the chances that the spasms can be effectively treated.
• A helpful mnemonic tool – an easily remembered acronym—is ‘STOP’ Infantile Spasms:
  • See the signs: Clusters of sudden, repeated, uncontrolled movements like head bobs or body crunching.
  • Take a video: Record the symptoms and talk to your doctor immediately.
  • Obtain diagnosis: Confirm an irregular brain wave pattern with an EEG test.
  • Prioritize treatment: End spasms to minimize developmental delays
• To download the STOP IS graphic elements, including the logo and animated video, click here.
  • Select the file you’d like to access and click on the “Download” button in the top right corner.
• The animated video can also be shared via YouTube.

We’re raising awareness about Infantile Spasms in hopes of a brighter future. Awareness leads to opportunity!

Each year, Infantile Spasms Awareness Week (ISAW) provides a unique opportunity to discuss disease awareness within the child neurology field.

• Held December 1-7, Infantile Spasms Awareness Week helps parents, as well as physicians and other health care providers, know about this disease and treatments.

Research is critical. Research about infantile spasms is gaining momentum.

The first-ever preventive epilepsy trial in the United States specific to infantile spasms in tuberous sclerosis complex is recruiting infants.

• About 80 percent of children with TSC develop epilepsy within the first three years of life, and infantile spasms occur in up to 35 percent of children with TSC.
• Some researchers believe that by identifying abnormal brain activity prior to the onset of seizures, we’ll be able to intervene earlier and prevent infantile spasms or other types of seizures.
• The study will recruit 80 infants with TSC at 15 sites across the country and aims to determine the impact of preventive treatment with Vigabatrin on the developmental outcomes of children at two years of age. We welcome those interested to contact the Tuberous Sclerosis Alliance at tsalliance.org or 800-225-6872.
• A clinical trial is recruiting newly diagnosed infants (aged 1-24 months) with infantile spasms to see if cannabidiol (CBD), used in combination with Vigabatrin for the treatment of IS, is better than Vigabatrin alone. To learn more, visit CNF’s clinical trial directory.

What Do Infantile Spasms Look Like?

VIDEO #1: In this first example, we see an infant with a cluster of individual spasms. Each spasm is less than one second long and heralded by sudden change in behavior with a look of surprise, wide opening of the eyes, brief stare, and elevation/extension of both arms. In between each spasm, the infant appears to be fine. This is very typical of infantile spasms.

VIDEO #2: Next, we see a 6 month old boy who similarly exhibits a cluster of spasms. Of particular note, each spasm is characterized by more vigorous extension of the right arm, in comparison to the left. This suggests that the seizures (spasms) originate in the left brain. This was confirmed by neurodiagnostic testing, and this boy underwent a successful hemispherectomy after several medications were unsuccessful. You can read more about his story at evanstauff.com.

VIDEO #3: The infant in this video experiences a cluster of spasms that is slightly different. Although each spasm in the cluster is brief, and similarly characterized by a sudden arrest of behavior with extension of both arms, we see that the spasms provoke an emotional reaction with crying—which momentarily stops with each spasm. This is fairly common and many children with infantile spasms have clusters accompanied by crying or fear. In contrast, some children experience unexpected laughter or happiness. The reasons for these emotional phenomena are not entirely clear but suggest that spasms often affect regions the brain responsible for emotion.

VIDEO #4: The next video shows an infant with fairly typical infantile spasms, with a vigorous head drop and simultaneous lifting of both arms. There is no clear asymmetry in the appearance of the spasms. Compare this video with the following VIDEO 5 – the same patient.

VIDEO #5: This shows the same infant presented in VIDEO #4. This video was recorded 10 weeks after the first video, following a course of therapy and partial improvement. Notice that the spasms are now “focal” and manifest with a much milder head-drop, and lifting of just the left arm. This suggests that the right brain is the source of the seizures (spasms). This example demonstrates how it is important not to assume that symmetric spasms exclude the possibility of a “focal” source of seizures.

We share this video, produced by the UK Infantile Spasms Trust and developed to raise public awareness of this rare but potentially devastating disease of infants. Find out more at ukinfantilespasmstrust.org

New Online Course from American Academy of Pediatrics (AAP) and American College of Emergency Physicians (ACEP) – Infantile Spasms: Early Recognition and Treatment

This online course is designed to help primary care and emergency physicians recognize and identify the typical signs and symptoms of infantile spasms. It will also review the most effective therapies for infantile spasms.

Learning objectives:

• Identify the typical signs and symptoms of infantile spasms in infants
• Recognize the various causes of infantile spasms
• Recognize that infantile spasms can occur in both infants who are developing typically, as well as infants with developmental delay
• Describe how early treatment of infantile spasms improves cognitive and developmental outcomes
• Select effective therapies for infantile spasms, using evidence-based medicine and American Academy of Neurology (AAN) practice guidelines

Course was developed by the American Academy of Pediatrics and the American College of Emergency Physicians, with practice guidelines from American Academy of Neurology – all members of ISAN. This PediaLink course was supported by the Child Neurology Foundation.

Register today. MOC/CME available. $29 for non-AAP members.

Patient Assistance Programs for Sabril® and Currently Available Generic Vigabatrin

Due to challenges reported by patients and providers, ISAN developed an informational table to help patients and health care provider understand currently available patient assistance programs and their requirements for Lundbeck Sabril®, and generic vigabatrin products offered by PAR Pharmaceutical, Amneal and Upsher-Smith as well as a private foundation offering help with co-pays. Additional information available here from our ISAN partner, TS Alliance.

Lundbeck Sabril®
SHAREPlus Program Support Center
888-457-4273

• Only new commercially insured patients one month to 2 years old with a confirmed diagnosis of infantile spasms and registered in the REMS system are eligible for a one-time 30-day supply while receiving insurance approval.
• No bridge supply offered for ongoing prescription.
• Co-pay assistance may be available for commercially insured patients. Click here for eligibility information.
• Other patient assistance may also be available. For more information, contact the Lundbeck Patient Assistance Program at 833-800-0119.

Amneal Pharmaceuticals Generic Vigabatrin for Oral Solution
Patient Support Program
877-369-5872

• Help with benefits verification and prior authorizations (PAs) and appeals.
• “Quick Start Shipments” provide a 5-day supply of product where a PA or appeal will take more than 24 hours to resolve.
• A second 5-day supply will be available for patients experiencing longer delays for coverage.
• Patient Assistant Program offers no-cost product for those who do not qualify for coverage, co-pay or alternate funding.
• Co-Pay Assistance where alternate funding assistance is not available for commercially insured patients (those without Medicare Part D or Medicaid).

PAR Pharmaceutical Generic Vigabatrin
Patient Assistance Resource
833-PAR-HELP (833-727-4357)

• Only for commercially insured patients one month to 2 years old with a confirmed diagnosis of infantile spasms.
• “Quick Start” pack will provide a 5-day supply for those requiring prior authorization.
• A second 5-day supply will be dispensed on an as-needed basis during insurance approval.
• For eligible patients, PAR provides co-pay assistance and patient assistance programs. For eligibility requirements, contact the Patient Assistance Resource numbers above.

Upsher-Smith VIGADRONE™
(vigabatrin) for Oral Solution Access Pathways® Program
866-923-1954 (M-F 8am-9pm ET; Fri-Sun 9pm-9pm ET)

• Available for new and existing patients.
• Starter Prescription / Bridge Prescription will provide a 7-day supply if there is any delay in getting a prescription filled (prior authorization, weekend, insurance change).
• Additional 7-day supply will be dispensed as needed if there are further delays due to insurance approval (up to 28 days per starter prescription).
• Access Pathways® provides co-pay and patient assistance for eligible patients. To learn more about these programs, contact Access Pathways® at the number above.
• For more information, click here

The Assistance Fund
Private Foundation Patient Support
844-762-9237

• Offers co-pay assistance program for infantile spasms only.
• Provides eligible underinsured individuals with financial assistance to cover all or part of the individuals’ out-of-pocket cost for the supported medications. These programs give individuals the ability to afford their medications.
• For more information, click here.

CNF thanks our 2021 partners – Mallinckrodt Pharmaceuticals, Upsher-Smith Laboratories and Zogenix – for their support.