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Epilepsy development in infancy with epileptic discharges

Harumi Yoshinaga1, Fumika Endo, Kennichi Kikumoto

  • 1Department of Child Neurology, Okayama University Graduate School of Medicine Dentistry and Pharmaceutical Sciences, Japan. magenta@md.okayama-u.ac.jp

Brain & Development
|September 29, 2006
PubMed

Insights

Early detection of epileptic discharges in infants with periventricular leukomalacia (PVL) is crucial. Prompt antiepileptic drug treatment for these infants may prevent the development of West syndrome (WS).

Area of Science:

  • Neonatal Neurology
  • Pediatric Epilepsy
  • Neurodevelopmental Disorders

Background:

  • West syndrome (WS) is a severe form of epilepsy in infancy.
  • Early identification of infants at risk is essential for timely intervention.
  • Periventricular leukomalacia (PVL) is a known risk factor for neurological impairments.

Purpose of the Study:

  • To investigate the epilepsy types developing in infants with early epileptic discharges.
  • To determine the association between periventricular leukomalacia (PVL) and West syndrome (WS) development.
  • To evaluate the efficacy of early antiepileptic drug (AED) treatment in preventing WS.

Main Methods:

  • Electroencephalogram (EEG) examinations were conducted on 116 infants.
  • 45 infants with early epileptic discharges were analyzed, grouped by the presence of PVL.
  • Retrospective observational study design with follow-up until April 2005.

Main Results:

  • 26 out of 45 infants with early epileptic discharges developed WS.
  • Infants with PVL had a significantly higher likelihood of developing WS compared to those without PVL.
  • 11 of 17 infants with PVL developed WS; all WS cases showed initial discharges before 5 months corrected age (CA).

Conclusions:

  • Periventricular leukomalacia (PVL) is a strong predictor for West syndrome (WS) development in infants with early epileptic discharges.
  • Early epileptic discharges before 3 months corrected age (CA) in preterm infants with PVL warrant prompt antiepileptic treatment.
  • Valproate (VPA) therapy showed potential in preventing WS in infants with hypsarrhythmia and improved EEG findings.

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