West syndrome following deep hypothermic infant cardiac surgery.
Postoperative seizures are among the more common complications of cardiac surgery in children. These seizures have traditionally been considered benign, transient phenomena with little, if any, prognostic significance. We report 4 infants with early postoperative seizures following cardiac surgery who later developed the previously unreported complication of West syndrome, with infantile spasms, hypsarrhythmia, and developmental delay. This group constitutes 6% of 67 infant spasms evaluated over a 5-year period at Boston Children's Hospital. The postoperative seizures in these 4 patients were more difficult than usual to control with antiepileptic therapy; otherwise no intra- or perioperative features distinguished these infants who later developed West syndrome from infants with apparently benign "postpump seizures."
du Plessis
A J
AJ
Department of Neurology, Children's Hospital, Boston, Massachusetts 02115.
Kramer
U
U
Jonas
R A
RA
Wessel
D L
DL
Riviello
J J
JJ
D000324:Adrenocorticotropic Hormone / Q000008:administration & dosage; D000927:Anticonvulsants / Q000008:administration & dosage; D002540:Cerebral Cortex / Q000187:drug effects / Q000503:physiopathology; D004569:Electroencephalography / Q000187:drug effects; D005071:Evoked Potentials / Q000187:drug effects; D005260:Female; D005500:Follow-Up Studies; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D007036:Hypothermia, Induced; D007223:Infant; D008297:Male; D011183:Postoperative Complications / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology; D013036:Spasms, Infantile / Q000188:drug therapy / Q000209:etiology* / Q000503:physiopathology
D000927:Anticonvulsants; D000324:Adrenocorticotropic Hormone