**Core Concept**
Infantile spasms are a type of severe epilepsy that affects infants, characterized by brief, muscle stiffening seizures. The management of infantile spasms involves the use of anti-epileptic medications that can help control the seizures and improve the quality of life for the affected infants.

**Why the Correct Answer is Right**
The drug of choice for the management of infantile spasms is Vigabatrin (Option C), which is a GABA transaminase inhibitor. Vigabatrin works by increasing the levels of GABA (gamma-aminobutyric acid), an inhibitory neurotransmitter in the brain, thereby helping to reduce the frequency and severity of seizures. This is particularly effective in infantile spasms due to its ability to cross the blood-brain barrier and act on the GABAergic system in the brain.

**Why Each Wrong Option is Incorrect**
* **Option A:** Adrenocorticotropic hormone (ACTH) is sometimes used in the treatment of infantile spasms, but it is not the first-line treatment and is associated with more side effects.
* **Option B:** Phenytoin is an anti-epileptic medication used in the treatment of various types of seizures, but it is not the preferred choice for infantile spasms.
* **Option D:** Topiramate is another anti-epileptic medication, but it is not the first-line treatment for infantile spasms.

**Clinical Pearl / High-Yield Fact**
Infantile spasms are often associated with underlying neurological disorders, such as tuberous sclerosis complex, and may require a comprehensive diagnostic evaluation to identify the underlying cause.

**Correct Answer: C. Vigabatrin**