ICNC Abstracts, ICNC 2018

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A clinical and electrophysiological profile of epileptic spasms- A tertiary care centre experience
abhishek ravindra jain, mary iype, P A Mohammed Kunju, mini sreedharan, bindu thankappan

Last modified: 2018-09-09

Abstract


Introduction: Epileptic spasms have varying aetiology and these seizures characteristically are seen as clusters. We evaluated the clinical and electrophysiological profile of 80 patients having epileptic spasms. Materials and methods: All patients with epileptic spasms diagnosed in the department from January 2008 to December 2013 who have now attained age between 5-10 years and who consented for a follow-up visit were included in the study. We excluded patients who expired and whose diagnosis of infantile spasms was uncertain. Results: Eighty children (males-39, females-41) were included in the study. Flexor spasms were seen in 69, extensor spasms in 10 and 1 had mixed spasms. Forty six children had other seizures in addition to infantile spasms (focal seizures, absences and generalised seizures). Spasms were seen as clusters in 63 and 17(21%) had single epileptic spasms. ACTH was used as initial definitive treatment in 75, Vigabatrin in 2 and oral steroids in 4 children. Twenty nine patients (36%) had neonatal encephalopathy (hypoxic ischemic encephalopathy, hyperbilirubinemia and prematurity), 7 had torch infections, 6 each had structural brain abnormality (4 holoprosencephaly, one aicardi syndrome, one focal cortical dysplasia), tuberous sclerosis, post menigitic sequelae and neonatal hypoglycaemia and 3 had inborn error of metabolism (one proven biotinidase deficiency). Thirteen cases were idiopathic, 2 had Down syndrome and there was one case each of epidermal nevus syndrome and Smith-Lemli-Opitz syndrome. Conclusion: Neonatal encephalopathy was the commonest cause we encountered in our series. We have also observed that 21% had single infantile spasms as reported by others.


Keywords


epileptic spasms

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