<prompt> In a child of infantile spasm and visual defect, which drug is not used even though it is highly effective?LamotrigineTopiramateACTHVigabatrin  <response>: Two types of drugs are used in infantile spasm: ACTH drug of choice Vigabatrin drug of choice if infantile spasm with Tuberous sclerosisVigabatrin is a GABA transaminase inhibitor. Major side-effect is visual field defect. It is indicated in Refractory focal seizures with impaired awareness.So, because of this side-effect it cant be used if the child already has visual defect. 