The EEG associated with this question is in a bipolar montage and showcases hypsarrhythmia, which is characterized by chaotic very-high-amplitude slow waves and spikes. At the asterisk, there is a discharge followed by a very brief period of electrodecrement, which is the classic EEG finding of infantile spasm. ACTH is considered to be the first-line therapy for idiopathic infantile spasms.