Outcomes of Epileptic Spasms in Patients Aged Less Than 3 Years: Single-Center United States Experience

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• 作者：Martina Vendrame ; MD ; PhDp>ap>p> ; p>p>bp>p> ; p>p>1p> ; Laura M.F.F. Guilhoto ; MD ; PhDp>ap>p> ; p>p>cp>p> ; p>p>1p> ; Tobias Loddenkemper ; MDp>ap> ; Matt Gregas ; PhDp>ap> ; Blaise F. Bourgeois ; MDp>ap> ; Sanjeev V. Kothare ; MDp>ap>p> ; p>p>sanjeev.kothare@childrens.harvard.edup>
• 刊名：Pediatric Neurology
• 出版年：2012
• 期刊代码：218_08878994
• 类别：med
• 出版时间：May, 2012
• 卷：46
• 期：5
• 页码：276-280
• 文件大小：132 K

摘要

Retrospective review was performed of children aged <3 years with epileptic spasms at our center from 2004-2010. Short-term (<6 months) and long-term (鈮? months) outcomes were assessed. We included 173 children (104 boys; median age of onset, 6.8 months) with epileptic spasms of known (62%) and unknown (38%) etiology. Treatments included adrenocorticotropic hormone (n聽= 103), vigabatrin (n聽= 82), phenobarbital (n聽= 34), and other agents (n聽= 121). Short-term treatment with adrenocorticotropic hormone and vigabatrin provided better epileptic spasm control in groups with known and unknown etiology than other agents. At follow-up (6-27 months), 54%of children manifested seizures, and 83%manifested developmental delay. Known etiology was a predictor of poor developmental outcome (P聽= 0.006), whereas bilateral/diffuse brain lesions predicted both poor development and seizures (P聽= 0.001 and 0.005, respectively). Initial presentations of epileptic spasms with hypotonia or developmental delay most strongly predicted both seizures and neurodevelopmental outcomes (P < 0.001). In a child presenting with epileptic spasms with developmental delay or hypotonia, no specific treatment may offer superior benefit.