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Infantile spasms: infectious disorders

R Riikonen1

  • 1Department of Child Neurology and Pediatrics, Children's Hospital, University of Helsinki, Finland.

Neuropediatrics
|October 1, 1993
PubMed
Summary
This summary is machine-generated.

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Infections, including cytomegalovirus (CMV) and herpes simplex virus, are significant causes of infantile spasms, leading to poor long-term outcomes. Early diagnosis and targeted treatments are crucial for affected infants.

Area of Science:

  • Neurology
  • Infectious Diseases
  • Pediatrics

Background:

  • Infections are identified as potential etiological factors in infantile spasms.
  • Congenital infections can manifest with early-onset tremor and convulsions.

Purpose of the Study:

  • To investigate the role of infections in infantile spasms.
  • To analyze the clinical presentation, EEG patterns, treatment response, and long-term outcomes in infants with infectious etiologies of infantile spasms.

Main Methods:

  • Retrospective analysis of patients with infantile spasms.
  • Identification of infectious agents including CMV, herpes simplex virus, rubella, enterovirus, adenovirus, and bacterial pathogens.
  • Evaluation of EEG patterns, brain CT findings, response to ACTH therapy, and long-term neurological outcomes.

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Main Results:

  • Infections were identified in 10% of patients with infantile spasms.
  • Congenital infections led to early tremor and convulsions.
  • Herpes simplex virus encephalitis showed a characteristic early EEG pattern.
  • Poor response to ACTH therapy (38%) and adverse long-term outcomes (90% mental retardation, 62% convulsions, 89% abnormal EEG) were observed.
  • Four deaths occurred within 7 years, with autopsy confirming CMV infection in two cases.

Conclusions:

  • Infectious etiologies, particularly viral encephalitis, are associated with particularly poor outcomes in infantile spasms.
  • Prevention, specific diagnosis, and timely treatment are critical.
  • Steroid therapy should be avoided in cases with a history of herpes virus encephalitis (CMV, herpes simplex).