Risk factors affecting prognosis in infantile spasm

Area of Science:

• Pediatric Neurology
• Epileptology
• Neurodevelopmental Disorders

Background:

• Infantile spasms (IS) represent a severe form of early-onset epilepsy.
• IS is associated with significant neurodevelopmental deficits and challenging epilepsy prognosis.
• Understanding prognostic factors is crucial for timely intervention and improved outcomes.

Purpose of the Study:

• To identify risk factors influencing neurodevelopmental outcomes in infantile spasms.
• To determine factors affecting epilepsy prognosis and treatment response in IS patients.
• To evaluate the long-term prognosis of infantile spasms.

Main Methods:

• Retrospective analysis of 104 patients diagnosed with infantile spasms.
• Assessment of demographics, treatment, etiology, and risk factors over a minimum 24-month follow-up.
• Statistical analysis to identify significant predictors of neurodevelopmental and epilepsy prognosis.

Main Results:

• Poor neurodevelopmental prognosis linked to neonatal seizures, abnormal head circumference, young age at presentation, symptomatic etiology, abnormal initial exams/development tests, consanguinity, and later treatment initiation center.
• Poor epilepsy prognosis associated with abnormal initial exams/development tests, consanguineous parents, young age at presentation, symptomatic etiology, and family history of intellectual disability/epilepsy.
• Adrenocorticotropic hormone (ACTH) demonstrated statistically significant efficacy for seizure control compared to other antiepileptic drugs.

Conclusions:

• Infantile spasms remain a catastrophic, age-related epileptic encephalopathy with significant long-term consequences.
• Etiology, age at presentation, and treatment initiation center are paramount factors influencing epilepsy prognosis.
• Early identification and intervention are critical for optimizing outcomes in infantile spasms.