Outcomes of epileptic spasms in patients aged less than 3 years: single-center United States experience.
Retrospective review was performed of children aged(<6 >months) and long-term (≥6 months) outcomes were assessed. We included 173 children (104 boys; median age of onset, 6.8 months) with epileptic spasms of known (62%) and unknown (38%) etiology. Treatments included adrenocorticotropic hormone (n = 103), vigabatrin (n = 82), phenobarbital (n = 34), and other agents (n = 121). Short-term treatment with adrenocorticotropic hormone and vigabatrin provided better epileptic spasm control in groups with known and unknown etiology than other agents. At follow-up (6-27 months), 54% of children manifested seizures, and 83% manifested developmental delay. Known etiology was a predictor of poor developmental outcome (P = 0.006), whereas bilateral/diffuse brain lesions predicted both poor development and seizures (P = 0.001 and 0.005, respectively). Initial presentations of epileptic spasms with hypotonia or developmental delay most strongly predicted both seizures and neurodevelopmental outcomes (P < 0.001). In a child presenting with epileptic spasms with developmental delay or hypotonia, no specific treatment may offer superior benefit.
Published In/Presented At
Vendrame, M., Guilhoto, L. M., Loddenkemper, T., Gregas, M., Bourgeois, B. F., & Kothare, S. V. (2012). Outcomes of epileptic spasms in patients aged less than 3 years: single-center United States experience. Pediatric neurology, 46(5), 276–280. https://doi.org/10.1016/j.pediatrneurol.2012.02.022
Medicine and Health Sciences
Department of Medicine