All issues > Volume 53(1); 2010

Original Article

Korean J Pediatr. 2010;53(1):80-84. Published online January 15, 2010.

Long-term outcomes of infantile spasms

Seak Hee SH Oh¹, Eun-Hye EH Lee¹, Min-Hee MH Joung¹, Mi-Sun MS Yum¹, Tae-Sung TS Ko¹

¹Department of Pediatrics, Asan Medical Center Children`s Hospital, University of Ulsan College of Medicine, Seoul, Korea.

Correspondence Tae-Sung TS Ko ,Tel: +82.2-3010-3725, Fax: +82.2-3010-3390, Email: tsko@amc.seoul.kr

Abstract

Purpose
: The aims of this study were to investigate the long-term outcomes in children with infantile spasms (IS) and to identify the prognostic factors influencing their neurodevelopment.
Methods
: We retrospectively evaluated seventy two children over five years old who were treated for IS at Asan Medical Center, Seoul, Korea, between 1994 and 2007. Forty-three children were contacted by telephone or medical follow-up to assess their current neurodevelopmental status. Multiple logistic regression was used to calculate odds ratios (ORs) and 95% confidence interval (95% CIs) of risk factors for unfavorable outcomes.
Results
: The mean follow-up duration for these 43 children was 7.2¡¾1.5 years (range, 4.5 to 13.0 years). Of these, 13 (30.2%) had cryptogenic and 30 (69.8%) had symptomatic IS. Eleven (25.6%) children were initially treated with adrenocorticotrophic hormone (ACTH) therapy, with a mean treatment lag of 1.3¡¾1.9 months (range; 0.1 to 7.0 months). Eighteen (41.8%) children clinically responded to initial treatment, as shown by EEG response. Overall, 22 (51.2%) children had at least moderate neurodevelopmental disorders and 2 (4.8%) died. In univariate analysis, etiology (symptomatic) and poor electroclinical response to initial treatment were related to long-term unfavorable outcomes. In multivariate analysis, response to primary treatment was the sole significant independent risk factor with a high OR.
Conclusion
: Overall prognosis of children with IS was poor. Electroclinical non-responsiveness to initial treatment was related to unfavorable long-term outcomes, indicating that initial control of seizures may be important in reducing the likelihood of poor neurodevelopment.

Keywords :Infantile spasm, Long-term outcome, Prognostic factor