Analysis of the causes of infant spasm_Journal of Epilepsy

Authors：

 ZHAJian , YIZhaoshi ,  ZHONGJianmin , CHENYong , YUXiongying , WUHuaping

Department of Pediatric Neurology, Jiangxi Children's Hospital, Nanchang 330006, China;

Corresponding author：

ZHONGJianmin, Email: zhongjm@163.com

Keywords：

Infantile spasms; West syndrome; Etiology

DOI：

10.7507/2096-0247.20160039

Video：

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Objective To analysis the causes of infant spasm (IS) and provide a theoretical basis for clinical diagnosis and treatment. Methods Collected the clinical data of 116 IS cases in our hospital from May 2011 to December 2013, which conform to the diagnostic standard, and analysis its causes. Results In the116 cases we collected, symptomatic IS is primarily for 78 cases (67.24%); the onset age of symptomatic IS within 6 months was 76.39% (55/72), higher than the rates of symptomatic IS beyond 6 months 52.27% (23/44) (P=0.007); The pathogenic factor in symptomatic IS, prenatal accounted for 48.72%, intrapartum factors accounted for 34.62%; for sexually transmitted diseases accounted for 47.44%, venereal disease accounted for 52.56%. In 78 cases of symptomatic IS, gender has no relation with its pathogenic factors; the onset age within 6 months of antepartum and intrapartum factor is significantly higher than the rates of symptomatic IS beyond 6 months (89.09% VS 69.57%); distribution between urban and rural areas and its pathogenic factors is related, prenatal factors of urban IS significantly lower than which in rural areas (38.30% VS 64.51%), intrapartum factor IS significantly higher than the rural IS (44.68% VS 19.35%). Conclusion The cause of the IS given priority to with symptomatic, IS in the majority with, and prenatal or developmental factors in the higher flight in symptomatic, and the smaller of the onset age antepartum and intrapartum factor becomes more apparent, prenatal factors in the rural areas is higher than which in the unban areas, but intrapartum factor in the unban areas is higher than which in the rural areas. Magnetic resonance imaging (MRI) still plays an important role in etiology diagnosis.

Citation： ZHAJian, YIZhaoshi, ZHONGJianmin, CHENYong, YUXiongying, WUHuaping. Analysis of the causes of infant spasm. Journal of Epilepsy, 2016, 2(3): 212-215. doi: 10.7507/2096-0247.20160039 Copy

1.	Karvelas G, Lortie A, Scantlebury MH, et al. A retrospective study on aetiology based outcome of infantile spasms. Seizure, 2009, 18(3):197-201.
2.	Lux AL, Osborne JP. A proposal for case definitions and outcome measures in studies of infantile spasms and West syndrome:consensus statement of the West Delphi group. Epilepsia, 2004, 45(11):1416-1428.
3.	Engel Jr J. ILAE classification of epilepsy syndromes. Epilepsy Res, 2006, 70(Suppl 1):5-10.
4.	Ohtahara S, Ohtsuka Y, Yamatogi Y, et al. Prenatal etiologies of West syndrome. Epilepsia, 1993, 34(4):716-722.
5.	Poulat AL, Lesca G, Sanlaville D, et al. A proposed diagnostic approach for infantile spasms based on a spectrum of variable aetiology. Eur J Paediatr Neurol, 2014, 18(2):176-182.
6.	甘靖, 屈艺, 罗蓉.婴儿痉挛症治疗进展.中华实用儿科临床杂志, 2014, 29(24):1889-1992.
7.	Güveli BT, Çokar Ö, Dörtcan N, et al. Long-term outcomes in patients with West syndrome:an outpatient clinical study. Seizure, 2015, 25(5):68-71.
8.	Fallah R, Salor F, Akhavan Karbasi S, et al. Randomised clinical efficacy trial of topiramate and nitrazepam in treatment of infantile spasms. Iran J Child Neurol, 2014, 8(1):12-19.
9.	Michaud JL, Lachance M, Hamdan FF, et al. The genetic landscape of infantile spasms. Human Molecular Genetics, 2014, 23(18):4846-4858.
10.	Du X, An Y, Yu L, et al. A genomic copy number variant analysis implicates the MBD5 and HNRNPU genes in Chinese children with infantile spasms and expands the clinical spectrum of 2q23.1 deletion. BMC Medical Genetics, 2014, 15(1):1-12.
11.	Riikonen RS. Favourable prognostic factors with infantile spasms. European Journal of Paediatric Neurology, 2010, 14(1):13-18.
12.	Karvelas G, Lortie A, Scantlebury MH, et al. A retrospective study on aetiology based outcome of infantile spasms. Seizure, 2009, 18(3):197-201.
13.	Osborne JP, Lux AL, Edwards SW, et al. The underlying etiology of infantile spasms (West syndrome):information from the United Kingdom Infantile Spasms Study (UKISS) on contemporary causes and their classification. Epilepsia, 2010, 51(10):2168-2174.
14.	Matsumoto A, Watanabe K, Negoro T, et al. Infantile Spasms:Etiological factors, Clinical aspects, and long term prognosis in 200 cases. Eur J Pediatr, 1981, 135(3):239-244.
15.	杨米凤, 肖农.儿童外伤后早期癫痫发作的临床特点及预后分析.癫痫杂志, 2015, 1(2):112-117.
16.	Paciorkowski AR, Thio LL, Dobyns WB. Genetic and biologic classification of infantile spasms. Pediatr Neurol, 2011, 45(6):355-367.

1. Karvelas G, Lortie A, Scantlebury MH, et al. A retrospective study on aetiology based outcome of infantile spasms. Seizure, 2009, 18(3):197-201.
2. Lux AL, Osborne JP. A proposal for case definitions and outcome measures in studies of infantile spasms and West syndrome:consensus statement of the West Delphi group. Epilepsia, 2004, 45(11):1416-1428.
3. Engel Jr J. ILAE classification of epilepsy syndromes. Epilepsy Res, 2006, 70(Suppl 1):5-10.
4. Ohtahara S, Ohtsuka Y, Yamatogi Y, et al. Prenatal etiologies of West syndrome. Epilepsia, 1993, 34(4):716-722.
5. Poulat AL, Lesca G, Sanlaville D, et al. A proposed diagnostic approach for infantile spasms based on a spectrum of variable aetiology. Eur J Paediatr Neurol, 2014, 18(2):176-182.
6. 甘靖, 屈艺, 罗蓉.婴儿痉挛症治疗进展.中华实用儿科临床杂志, 2014, 29(24):1889-1992.
7. Güveli BT, Çokar Ö, Dörtcan N, et al. Long-term outcomes in patients with West syndrome:an outpatient clinical study. Seizure, 2015, 25(5):68-71.
8. Fallah R, Salor F, Akhavan Karbasi S, et al. Randomised clinical efficacy trial of topiramate and nitrazepam in treatment of infantile spasms. Iran J Child Neurol, 2014, 8(1):12-19.
9. Michaud JL, Lachance M, Hamdan FF, et al. The genetic landscape of infantile spasms. Human Molecular Genetics, 2014, 23(18):4846-4858.
10. Du X, An Y, Yu L, et al. A genomic copy number variant analysis implicates the MBD5 and HNRNPU genes in Chinese children with infantile spasms and expands the clinical spectrum of 2q23.1 deletion. BMC Medical Genetics, 2014, 15(1):1-12.
11. Riikonen RS. Favourable prognostic factors with infantile spasms. European Journal of Paediatric Neurology, 2010, 14(1):13-18.
12. Karvelas G, Lortie A, Scantlebury MH, et al. A retrospective study on aetiology based outcome of infantile spasms. Seizure, 2009, 18(3):197-201.
13. Osborne JP, Lux AL, Edwards SW, et al. The underlying etiology of infantile spasms (West syndrome):information from the United Kingdom Infantile Spasms Study (UKISS) on contemporary causes and their classification. Epilepsia, 2010, 51(10):2168-2174.
14. Matsumoto A, Watanabe K, Negoro T, et al. Infantile Spasms:Etiological factors, Clinical aspects, and long term prognosis in 200 cases. Eur J Pediatr, 1981, 135(3):239-244.
15. 杨米凤, 肖农.儿童外伤后早期癫痫发作的临床特点及预后分析.癫痫杂志, 2015, 1(2):112-117.
16. Paciorkowski AR, Thio LL, Dobyns WB. Genetic and biologic classification of infantile spasms. Pediatr Neurol, 2011, 45(6):355-367.

Journal of Epilepsy

Analysis of the causes of infant spasm

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