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Published on: July 8, 2025
Outcome of patients with infantile spasms
Smail Zubcevic1, Selma Tanovic, Feriha Catibusic
1Department of Pediatric Neurology, Pediatric Clinic, University Clinical Centre Sarajevo, Bosnia and Herzegovina.
Insights
Infantile spasms (IS) in children present a significant challenge, particularly in developing nations. Despite limited treatment options, outcomes in seizure control and psychomotor development were comparable to international reports.
Area of Science:
- Pediatric Neurology
- Developmental Pediatrics
- Clinical Research
Background:
- Infantile spasms (IS) are a severe form of epilepsy in infants.
- Early diagnosis and treatment are crucial for optimal outcomes.
- Limited resources in developing countries can impact treatment accessibility and efficacy.
Purpose of the Study:
- To evaluate the treatment outcomes of children diagnosed with infantile spasms (IS) between 2002 and 2006.
- To describe the clinical characteristics of IS patients at the University Clinical Center in Sarajevo.
- To assess the long-term psychomotor development and seizure control in this cohort.
Main Methods:
- Retrospective analysis of 19 IS patients (2002-2006).
- Inclusion of detailed medical histories, video-EEG, neuroimaging, and laboratory studies.
- Assessment of seizure frequency, therapeutic response, and neurodevelopmental status.
Main Results:
- Symptomatic IS accounted for 78.9% of cases; cryptogenic IS in 21.1%.
- Satisfactory therapeutic response (seizure-free or >50% reduction) achieved in 89.5% of patients.
- At follow-up (mean 42.5 months), 36.8% had severe psychomotor retardation; 4 patients (21.1%) were seizure-free with normal development.
Conclusions:
- Treatment of IS is challenging, especially in resource-limited settings like Bosnia and Herzegovina.
- Despite treatment limitations, seizure control and psychomotor development outcomes were comparable to international data.
- Further research into prognostic predictors and pathophysiology may lead to improved therapies for IS.
Purpose:
To assess outcome of children diagnosed with infantile spasms (IS) during the six-year-period (2002-20006), at the Pediatric Clinic of Clinical Center of University of Sarajevo, as well as to present other important clinical characteristics in this group of patients.
Methods:
All patients had medical histories with detailed description orvideo recordings of their seizures, as well as profound neurological exam, series of video-EEG registrations, neuroimaging studies and laboratory studies that were possible to perform.
Results:
Total of 19 patients with IS were treated (14 male, 5 female). Etiologically symptomatic IS were present in 78.9% of cases, cryptogenic in 21.1%. Flexor and mixed spasms were the most common (47.4% and 31.6% respectively). Therapeutic response was satisfactory: 42.1% of patients were seizure-free, 47.4% had partial response with more than 50% decrease of seizures, 10.5% had poor therapeutic response. Most of the patients were treated with polytherapy. The follow-up period was 15-70 months (mean 42.5 months). At last check-up four patients had normal development and were without seizures, two were lost to follow-up, two patients have died (21.4%, 10.5% and 10.5% respectively). Out of remaining patients seven (36.8% of total) had a severe psychomotor retardation with spastic tetraparesis, while the rest had hemiparesis and developmental difficulties.
Discussion:
Treatment of infantile spasms presents a great challenge, especially in the developing countries like Bosnia and Herzegovina in which the treatment modalities are limited. Our results indicate that despite the lack of the proper treatment options, outcome of the patients regarding control of seizures and latter psychomotor development did not differ significantly from the reports from the other countries.
Conclusion:
Although prognosis for most patients with infantile spasms remains poor, further studies identifying predictors of favorable prognosis and recent advances in understanding the pathophysiology of infantile spasms offer hope of safer and more-effective therapies that improve long-term outcome.
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