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Study of Thirty Two Patients with Infantile Spasms Admitted to Baghdad Medical City

Raed Jabbar Hussain*, Maher Mahdi Salih**, Kefah Essa Nader***, Mahjoop N. AL-naddawi****

Iraqi Academic Scientific Journal المجلة العراقية للاختصاصات الطبية
ISSN: 16088360 Year: 2017 Volume: 16 Issue: 2 Pages: 144-150
Publisher: The Iraqi Borad for Medical Specialization المجلس العراقي للاختصاصات الطبية

Abstract

ABSTRACT:BACKGROUND: Infantile spasms is rare epileptic syndrome affect most often infants in first year of life, occur in paroxysmal attacks in clusters especially in periods of sleep transition range in number from few spasms to many up to one hundred, and associated with crying and abnormal behavior .OBJECTIVES: Study various aspects of conditioncauses, clinical features, electroencephalograms, radiological imaging, therapeutics choices, identification the variations in our patients and outcome. PATIENTS AND METHODS:the study enrolled thirty two infants referred to child welfare hospital and epilepsy clinic of Baghdad teaching hospital in medical city of Baghdad and were followed up in outpatient clinic of these hospitals for a period extend From beginning of January 2015 to end of January 2016. All data are encoded in patient file and discharging card. Study design was hospital based description of data from patients'records.RESULTS: Male-female ratio is 1:1 , age of presentation range from four to ten month,lag period between early seizures and diagnosis was range from two weeks to four months . two weeks in two cases four week in 20 cases ( 62 % ) , 10 cases present with more than four weeks delay (31.25%)seizure types were flexor spasms in 14 (43.75%) , extensor in 6 (18.75%) , and mixed in 12 patients (37.5%) , symptomatic cases were 24 (75 %) , idiopathic in 8 (25 %).Mode of delivery (18 patients delivered by caesarean section 56.25 %, 14 patients 43.75 % delivered by normal vaginal mode). Causes and gender relation, was that Symptomatic was more than idiopathic in both genders.The relation of gender to etiologic types, Tuberous sclerosis was the most common etiology in female, but neonatal and other disorders was the most common etiology in male. In Response to treatment and outcome ,16 patient (50%) had Complete remission of spasms, and 15 patient (50%) end with Severe developmental delay . CONCLUSION: Flexor type is commonest clinical types. Symptomatic group is predominant etiological types, neurocutaneous syndrome is commonest cause in symptomatic group .Hypsarrthmia is documented in majority of patients Brain atrophy is the commonest in radiological films .Steroids is main treatment. Infantile spasms had poor prognosis, in terms of neurobehavioral development..

Keywords

KEYWORDS:epilepticspasms --- hypsarrthmia --- developmental delays --- ACTH