POMC and tuberous sclerosis: In 2009, the U.S. Food and Drug Administration approved adrenocorticotropic hormone (ACTH) and vigabatrin as the first line of therapy for West syndrome, and in 2012 evidence-based updated practice guidelines indicated no clear preference of ACTH and vigabatrin [7], with the exception of children who had underlying tuberous sclerosis, for which vigabatrin was the reported treatment of choice [1, 5].