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Infantile spasms associated with theophylline toxicity
M D Shields1, E M Hicks, D F Macgregor
1Royal Belfast Hospital for Sick Children, Northern Ireland.
Acta Paediatrica (Oslo, Norway : 1992)
|February 1, 1995
Summary
A 6-month-old infant experienced infantile spasms and abnormal EEG results linked to theophylline treatment for asthma. Symptoms resolved after discontinuing theophylline, suggesting a causal relationship.
Area of Science:
- Pediatric Neurology
- Clinical Pharmacology
- Asthma Management
Background:
- Asthma is a common chronic respiratory disease in infants.
- Theophylline is a bronchodilator sometimes used in asthma treatment.
- Infantile spasms are a severe form of epilepsy in infants.
Observation:
- A 6-month-old infant with asthma developed spasms and hypsarrhythmia on electroencephalogram (EEG).
- These symptoms emerged shortly after initiating oral theophylline.
- Theophylline levels were slightly elevated, just above the normal range.
Findings:
- Discontinuation of theophylline led to the cessation of spasms.
- EEG normalization occurred after theophylline withdrawal and initiation of nitrazepam.
- The infant exhibited normal neurodevelopment over a 3-year follow-up period.
Implications:
- Theophylline toxicity may precipitate infantile spasms in susceptible infants.
- Careful monitoring of theophylline levels and potential neurological side effects is crucial.
- Prompt recognition and management can lead to favorable neurodevelopmental outcomes.