Quantitative Characteristics of Hypsarrhythmia in Infantile Spasms

Infantile spasms is a type of epilepsy characterized by clinical seizures termed "spasms" and often an electroencephalographic (EEG) pattern known as hypsarrhythmia. Multiple studies have shown that the interrater reliability for human visual recognition of hypsarrhythmia is poor. Quantitative measurements of this EEG pattern would provide objective basis for identification; however, the basic temporal and spectral characteristics of hypsarrhythmia have never been assessed. Thus, we measured EEG amplitude and power spectra in 21 infantile spasms patients before and after treatment, as well as 21 control subjects. The hypsarrhythmia EEG pattern was associated with (1) high broadband amplitude, especially in frontal and central brain regions, (2) high median power in the delta and alpha frequency bands, and (3) low spectral edge frequency. Our results indicate that hypsarrhythmia can be quantitatively distinguished from data without hypsarrhythmia. Introduction of these quantitative measures into clinical practice may increase diagnostic accuracy, expediting proper treatment and improving outcomes.