Predictors of outcome among 31 children with infantile spasms syndrome

Area of Science:

• Pediatric Neurology
• Developmental Neuroscience
• Epileptology

Background:

• Infantile spasms syndrome (ISS) is a severe epileptic encephalopathy often associated with neurodevelopmental delay.
• Managing ISS is challenging due to pharmacoresistant epilepsy and seizure relapses.
• Predicting neurodevelopmental outcomes in affected children is critical for timely intervention.

Purpose of the Study:

• To identify predictors of neurodevelopmental outcomes in patients diagnosed with infantile spasms syndrome.
• To establish factors that correlate with developmental trajectories in infants with ISS.
• To guide clinical management and parental counseling regarding prognosis in ISS.

Main Methods:

• Prospective evaluation of 31 patients with infantile spasms from 2014-2017.
• Assessment included demographic data, video-electroencephalography (EEG), brain magnetic resonance imaging (MRI), and neurodevelopmental evaluations (ASQ).
• Parental diaries tracked spasms, and children were followed for one and two years post-assessment.

Main Results:

• Neurodevelopmental deterioration observed in 61.1% (second) and 53% (third) evaluations for infants with spasm onset before seven months.
• Low scores on the Ages and Stages Questionnaire (ASQ) communication domain were noted in patients with structural brain abnormalities.
• Eleven patients with pre-existing developmental delay showed significant developmental regression (p=0.01).

Conclusions:

• Early infantile spasms onset (before seven months), pre-existing developmental delay, low ASQ scores, and structural MRI abnormalities are significant predictors of poor developmental outcomes.
• These findings underscore the importance of early clinical evaluation and prognosis communication to parents.
• Prompt initiation of interventions is recommended to improve developmental trajectories in infants with ISS.