POMC and Epileptic spasm: At 4.5 months, his seizure pattern changed to epileptic spasms, and despite treatment with adrenocorticotropic hormone (did not try prednisolone PO) and various anti-seizure medications (oxcarbazepine 35 mg/kg/d, vigabatrin 100 mg/kg/d, topiramate 5 mg/kg/d, lamotrigine 4 mg/kg/d, clobazam 1 mg/d, perampanel 2 mg/d, zonisamide 6 mg/d), they remained uncontrolled.