Archives of Disease in Childhood 2008;93:462-463
Leading articles
The management of infantile spasms
1 APHP, Paediatric Neurology, Hôpital Necker, Paris, France
2 INSERM, U663, Paris, France
3 Université Paris Descartes, Paris, France
Olivier Dulac, APHP, Paediatric Neurology, Hôpital Necker, 149 Rue de Sèvres, 75015 Paris, France; o.dulac@nck.aphp.fr
Accepted 10 November 2007
| The first 150 words of the full text of this article appear below. |
Infantile spasms (IS) is the most frequent epilepsy syndrome in infancy. Although the consensus triad of spasms in clusters with hypsarrhythmia adversely affecting psychomotor development1 seems quite straightforward, the great variability of each component is a challenge not only to the clinician involved in management of the condition but also to the methodologist designing trials for treatment issues.
Indeed, the spasms may be symmetrical, asymmetrical or mixed, and florid and easy to identify or reduced to eye movements with crying that require video polygraphy including muscular recording for identification as ictal events.2 For weeks the diagnosis may be misdiagnosed as gastrointestinal disturbance until an EEG is performed. Ictal EEG may consist of a diffuse high amplitude slow wave, electrodecrement or low amplitude fast activity, or even be combined with focal discharge. The distinction between spasms and myoclonic or brief tonic seizures may be difficult, particularly in very young infants. The
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