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Clinical and Therapeutic Strategies for West Syndrome in Low-Resource Settings: A 10-Year Experience From Cameroon

Dominique Enyama1,2, Joël Aquilas Ngalandeu Kwemo3, Diomede Noukeu Njinkui1,2

  • 1Faculty of Medicine and Pharmaceutical Sciences, University of Dschang, Dschang, Cameroon.

Journal of Paediatrics and Child Health
|March 16, 2026
PubMed

Insights

Infantile epileptic spasm syndrome (IESS) has a high mortality rate and causes significant developmental delays in affected children. Early diagnosis and intervention are crucial for improving outcomes in low-resource settings.

Area of Science:

  • Pediatric Neurology
  • Neonatal Medicine
  • Public Health

Background:

  • Infantile Epileptic Spasm Syndrome (IESS) is a severe epilepsy syndrome with significant morbidity and mortality.
  • Early diagnosis and treatment are critical for improving outcomes in infants with IESS.
  • Low-resource settings face unique challenges in managing IESS, including diagnostic delays and limited access to treatment.

Purpose of the Study:

  • To determine the prevalence, clinical characteristics, etiologies, and outcomes of Infantile Epileptic Spasm Syndrome (IESS) in a low-resource setting.
  • To identify factors contributing to diagnostic delays and poor outcomes in IESS.
  • To inform the development of targeted interventions for improving IESS management in resource-limited environments.

Main Methods:

  • Retrospective cohort study of 84 children diagnosed with IESS between 2015-2024.
  • Review of medical records and follow-up clinical assessments of 67 children.
  • Analysis of socio-demographic, clinical, and therapeutic data using SPSS.

Main Results:

  • IESS prevalence was 0.34%, with a median diagnostic delay of 2 months; 65.5% of families initially sought traditional medicine.
  • Common etiologies included perinatal asphyxia (64.3%) and neonatal infections (72.6%). Hypsarrhythmia was present in 97.6% of cases.
  • Outcomes were poor, with 25.4% mortality and 90.0% experiencing developmental delays; corticosteroids were the primary treatment (78.6%).

Conclusions:

  • High mortality and developmental delays in IESS underscore the need for early diagnostic algorithms and discouraging traditional medicine use.
  • Improving neonatal infection control and ensuring corticosteroid availability are vital.
  • Paediatric neurology teleconsultation can enhance outcomes in low-resource settings for IESS management.
Abstract

Keywords:
CameroonWest syndromediagnosisepilepsyinfantile epileptic spasm syndromelow‐resource settingtreatment

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