Infantile spasms

• What are infantile spasms?


  Also known as West syndrome

  Type of childhood epilepsy

  Typically presents in first 4-8 months of life

  More common in male infants
• Infantile spasms are often associated with a serious underlying condition & has a poor prognosis.
• What are the features of infantile spasms?


  Characteristic 'salaam' attacks -> flexion of head, trunk & arms followed by extension of arms

  Lasts around 1-2 secs, may be repeated up to 50 times

  Progressive mental handicap
• What are the Inx for infantile spasms?


  Obs

  Full Hx & examination

  EEG

  CT
• What are the RFs of infantile spasms?


  Brain malformation

  Neurocutaneous abnormalities

  Antenatal or perinatal vascular event

  Intrauterine or perinatal infections

  Inherited metabolic disorder

  Genetic disorder
• What are the DDx of infantile spasms?


  Benign familial infantile spasms

  Reflux

  Infantile colic

  Benign infantile head drops
• What is the management of infantile spasms?


  Vigabatrin (1st line)

  ACTH
• What are the potential complications of infantile spasms?


  Lennox-Gastaut syndrome

  Other epilepsy syndromes

  Developmental delay

  Reduced life expectancy