Complications
A severe form of childhood epilepsy, characterised by a predominance of tonic and atonic seizures and atypical absence seizures. This epilepsy syndrome can evolve from infantile spasms.
The electroencephalogram shows diffuse interictal slow spike-wave discharges of about 2.5 Hz activity.
Most children have psychomotor retardation.
Epilepsy following infantile spasms occurs in approximately 60% of patients. Apart from Lennox-Gastaut, focal seizures with impaired awareness are the most common. The development of epilepsy, as well as the prognosis for intellectual development, is strongly influenced by the underlying aetiology.
Poor prognostic factors include an early age of onset, structural brain abnormalities, and other seizure types occurring before the onset of spasms.
Most patients have developmental delay, which may precede or follow the onset of seizures. Learning difficulties ranging from mild to severe are common. Ongoing developmental assessment and multidisciplinary support is vital.
This depends on the aetiology of the infantile spasms rather than the seizures themselves.
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