<prompt> The drug of choice in treatment of inflantile spasms isPhenytoinPhenobarbitoneCarbamazepinACTH  <response>: Infantile spasms:-West syndromeOnset : 3-8 months of lifeCharacterised by combination of salaam spells sudden dropping of the head and flexion of arms, developmental retardation, hypsarrythmia on ECG.Causes-Hypoxic ischemic encephalopathyNeurocutaneous syndromesPerinatal infectionsHemorrhageInjuryMetabolic disordersLocalized structural malformations The spasms occur in clusters usually on wakingDrug therapy-Intramuscular ACTH 40-60 unit per day may be given 4-6 weeks and tgen tapered off.On the other hand oral prednisolone at 2 mg kg day in divided doses may also be used.These agents abolish spasms and may result in resolution of hypsarrythmia. 