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Outcome for West syndrome following surgical treatment
B M Uthman1, S A Reid, B J Wilder
1Department of Neurology, VA Medical Center, Gainesville, FL 32608.
Insights
Surgical removal of a porencephalic cyst successfully treated infantile spasms in a child. The patient experienced seizure freedom and normalized EEG after surgery, indicating surgery
Area of Science:
- Pediatric Neurology
- Neurosurgery
Background:
- Infantile spasms are a severe epilepsy syndrome in infants.
- Hypsarrhythmia on EEG is characteristic of infantile spasms.
- Porencephalic cysts are brain abnormalities that can be associated with epilepsy.
Observation:
- An 18-month-old child presented with infantile spasms and hypsarrhythmia.
- The patient had a co-existing porencephalic cyst.
- Medical therapy for the spasms was unsuccessful.
Findings:
- Surgical removal of the porencephalic cyst and surrounding tissue was performed.
- The patient achieved 12 months of seizure freedom post-surgery.
- Electroencephalogram (EEG) patterns normalized after the intervention.
Implications:
- Surgical treatment may be effective for selected infantile spasms cases with focal central nervous system (CNS) lesions.
- This case highlights the potential benefit of addressing structural brain abnormalities in refractory epilepsy.
- Further research into surgical outcomes for infantile spasms associated with specific lesions is warranted.
Abstract:
We report the case of an 18-month-old child with infantile spasms and a hypsarrhythmic electroencephalogram (EEG) pattern associated with a porencephalic cyst. Surgical removal of the cyst and its surrounding tissue was performed following failure of medical therapy. Postoperatively, the patient has been free of infantile spasms for 12 months and the EEG has normalized. He has been maintained on the same preoperative antiepileptic medications. This case suggests that surgical treatment is helpful in selected patients with infantile spasms and focal CNS lesions.