Infantile spasms. A retrospective study of 105 cases

Area of Science:

• Pediatrics
• Neurology
• Clinical Medicine

Background:

• Infantile spasms present significant diagnostic and therapeutic challenges.
• Delayed presentation for treatment is common, impacting prognosis.
• Etiologies are diverse, including genetic and environmental factors.

Purpose of the Study:

• To summarize clinical observations and treatment outcomes in 105 infantile spasms cases.
• To investigate potential correlations between trace element levels and infantile spasms.
• To evaluate the efficacy of Sodium valproate, prednisone, and ACTH in treating infantile spasms.

Main Methods:

• Clinical case series analysis of 105 patients with infantile spasms.
• Electroencephalography (EEG) and brain stem auditory evoked potentials (BAEPs) were utilized.
• Computed tomography (CT) scans and hair trace element analysis (PIXE) were performed.

Main Results:

• Patients presented around one year after symptom onset, with diverse triggers noted.
• EEG showed characteristic or modified arrhythmia; abnormal BAEPs in one-third of cases.
• CT scans suggested no significant brain atrophy progression during ACTH treatment.
• Significant differences in hair lead, calcium, and zinc levels were observed in patients versus controls.
• Sodium valproate, prednisone, and ACTH demonstrated treatment efficacy, with notable improvements in many patients.

Conclusions:

• ACTH, prednisone, and sodium valproate are effective treatments for infantile spasms.
• Trace element imbalances, particularly in lead, calcium, and zinc, may be associated with infantile spasms.
• Further research into pathogenesis and optimal treatment timing is warranted.