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Brain tumors associated with infantile spasms
1Department of Pediatrics, Sapporo Medical University, School of Medicine, Japan.
Insights
Brain tumors may cause infantile spasms in infants. Treatment with adrenocorticotropic hormone and clonazepam relieved seizures in two cases, suggesting focal lesions contribute to infantile spasms.
Area of Science:
- Neurology
- Pediatric Neurology
- Neuro-oncology
Background:
- Infantile spasms (IS) are a severe epilepsy syndrome in infants.
- The etiology of IS is often unknown, but focal brain lesions are increasingly recognized as a cause.
Observation:
- Two infants presented with typical infantile spasms, including tonic seizures and hypsarrhythmia.
- Patient 1 had a hypothalamic hamartoma; Patient 2 had a primary brain tumor (mixed-oligoastrocytoma) with calcification.
- Both infants' seizures resolved with adrenocorticotropic hormone therapy and clonazepam.
Findings:
- Focal brain lesions, such as hypothalamic hamartoma and mixed-oligoastrocytoma, can be associated with infantile spasms.
- Surgical resection was not feasible for the hypothalamic hamartoma due to its location and lack of a stalk.
Implications:
- This case series suggests a potential causal link between specific focal brain lesions and the development of infantile spasms.
- Early identification and characterization of brain lesions may be crucial for managing infantile spasms.
Abstract:
Two patients with brain tumors associated with infantile spasms are reported. Both infants displayed typical clinical features of infantile spasms, comprising tonic spasms manifesting in series and hypsarrythmia. In Patient 1, magnetic resonance imaging revealed a tumor in the hypothalamic region, suggestive of hypothalamic hamartoma. In Patient 2, cranial computed tomography and magnetic resonance imaging indicated the existence of a primary brain tumor with calcification in the right temporal lobe. Adrenocorticotropic hormone therapy combined with clonazepam relieved seizures in both infants. In Patient 1, resection of the hypothalamic tumor is impossible because the tumor lacks a stalk. In Patient 2, pathologic investigation of removed tumor tissue demonstrated mixed-oligoastrocytoma. It is suggested that focal lesions, like those in our patients, are involved in the development of infantile spasms.