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Related Experiment Videos

Asymmetric and asynchronous infantile spasms

E K Gaily1, D A Shewmon, H T Chugani

  • 1Department of Pediatrics, UCLA Medical Center, USA.

Epilepsia
|September 1, 1995
PubMed
Summary
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Asymmetric infantile spasms, often linked to brain abnormalities, suggest localized epilepsy. This finding may help identify a specific subset of symptomatic infantile epilepsy.

Area of Science:

  • Neurology
  • Epileptology
  • Pediatric Neurology

Background:

  • Infantile spasms typically present with symmetric electroencephalogram (EEG) and behavioral patterns.
  • Asymmetric and asynchronous infantile spasms are less common, with limited research on their EEG correlation and localization.
  • Understanding these atypical spasms is crucial for diagnosing and managing infantile epilepsy.

Purpose of the Study:

  • To investigate the relationship between asymmetric/asynchronous infantile spasms, ictal EEG, and underlying brain pathology.
  • To determine if asymmetric spasms correlate with specific neuroimaging findings and seizure types.
  • To explore the potential for a unique subset of localization-related infantile epilepsy characterized by asymmetric spasms.

Main Methods:

Related Experiment Videos

  • Review of 75 consecutive video-EEG recordings of infantile spasms.
  • Scoring of 8,680 spasms for behavioral and EEG asymmetry/asynchrony.
  • Correlation of spasm characteristics with baseline EEG, MRI, PET scans, and neurological examinations.

    • Main Results:

    • 25% of spasms were asymmetric, and 7% were asynchronous.
    • Asymmetric/asynchronous spasms were often associated with contralateral ictal EEG discharge.
    • Patients with predominantly asymmetric/asynchronous spasms showed more contralateral central brain abnormalities and frequent partial motor seizures.

    Conclusions:

    • Asymmetric and asynchronous infantile spasms likely originate from a contralateral cortical epileptogenic zone involving the primary sensorimotor area.
    • The combination of asymmetric spasms, ipsilateral partial motor seizures, and contralateral central pathology may define a distinct subtype of symptomatic localization-related infantile epilepsy.