Outcomes of epileptic spasms in patients aged less than 3 years: single-center United States experience.

Abstract

Retrospective review was performed of children aged <3 years with epileptic spasms at our center from 2004-2010. Short-term (<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.

• Authors: Martina Vendrame, Laura M F F Guilhoto, Tobias Loddenkemper, Matt Gregas, Blaise F Bourgeois, Sanjeev V Kothare
• Journal: Pediatric neurology (Pediatr Neurol) Vol. 46 Issue 5 Pg. 276-80 (May 2012) ISSN: 1873-5150 [Electronic] United States
• PMID: 22520347 (Publication Type: Journal Article)
• Copyright: Copyright © 2012 Elsevier Inc. All rights reserved.

Chemical References

• Anticonvulsants
• Adrenocorticotropic Hormone
• Vigabatrin
• Phenobarbital

Topics

• Adrenocorticotropic Hormone (therapeutic use)
• Anticonvulsants (therapeutic use)
• Electroencephalography
• Female
• Humans
• Infant
• Male
• Phenobarbital (therapeutic use)
• Retrospective Studies
• Spasms, Infantile (drug therapy, epidemiology)
• Treatment Outcome
• United States (epidemiology)
• Vigabatrin (therapeutic use)