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http://dx.doi.org/10.3345/kjp.2010.53.1.80

Long-term outcomes of infantile spasms  

Oh, Seak Hee (Department of Pediatrics, Asan Medical Center Children's Hospital University of Ulsan College of Medicine)
Lee, Eun-Hye (Department of Pediatrics, Asan Medical Center Children's Hospital University of Ulsan College of Medicine)
Joung, Min-Hee (Department of Pediatrics, Asan Medical Center Children's Hospital University of Ulsan College of Medicine)
Yum, Mi-Sun (Department of Pediatrics, Asan Medical Center Children's Hospital University of Ulsan College of Medicine)
Ko, Tae-Sung (Department of Pediatrics, Asan Medical Center Children's Hospital University of Ulsan College of Medicine)
Publication Information
Clinical and Experimental Pediatrics / v.53, no.1, 2010 , pp. 80-84 More about this Journal
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 $7.2{\pm}1.5$ 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 $1.3{\pm}1.9$ 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.
Keywords
Infantile spasm; Long-term outcome; Prognostic factor;
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