This is a real-world medical entrance exam question, please give the true answer based on the question and selection. Topic name: None, Subject name: Pediatrics
The drug of choice in treatment of inflantile spasms is 
Select and explain. 
A. Phenytoin, B. Phenobarbitone, C. Carbamazepin, D. ACTH
D: ACTH
Answer: D: ACTH 
Explanation: Infantile spasms:-

West syndrome
Onset : 3-8 months of life
Characterised by combination of salaam spells( sudden dropping of the head and flexion of arms), developmental retardation, hypsarrythmia on ECG.

Causes-

Hypoxic ischemic encephalopathy
Neurocutaneous syndromes
Perinatal infections
Hemorrhage
Injury
Metabolic disorders
Localized structural malformations 
The spasms occur in clusters usually on waking

Drug 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.