Long-term outcomes of infantile spasms.
- Author:
Seak Hee OH
1
;
Eun Hye LEE
;
Min Hee JOUNG
;
Mi Sun YUM
;
Tae Sung KO
Author Information
- Publication Type:Original Article
- Keywords: Infantile spasm; Long-term outcome; Prognostic factor
- MeSH: Adrenocorticotropic Hormone; Child; Electroencephalography; Follow-Up Studies; Humans; Infant; Infant, Newborn; Korea; Logistic Models; Multivariate Analysis; Odds Ratio; Prognosis; Retrospective Studies; Risk Factors; Seizures; Spasms, Infantile; Telephone
- From:Korean Journal of Pediatrics 2010;53(1):80-84
- CountryRepublic of Korea
- Language:English
- 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+/-1.5 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+/-1.9 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.
