Infantile spasms: neurological and developmental follow-up--a comparison between two ethnic groups: Israeli Jews and Bedouin in the South of Israel.
BACKGROUND
The aim of this study was to examine all cases of infantile spasms (IS) diagnosed at the Soroka University Medical Center, Ben Gurion University, Israel during 1981--1997.


METHODS
31 children, 17 (55%) males. 17 (55%) were Jews and 14 (45%) Bedouins. Four (13%) died. Data was gathered from hospital files, neuropediatric unit and Zusman Child Development Center. Demographic and ethnic data, characteristics of the disease type of seizures, EEG pattern imaging studies, type of treatment, psychomotor development, rehabilitation and educational services were analysed.


RESULTS
Mean age at diagnosis 7.22 months. Etiology for one third was pre- or perinatal insult, one third postnatal and one third unknown. 26 (84%) were symptomatic and five (16%) cryptogenic. Significant statistical difference was found with more Bedouin children symptomatic with moderate or severe mental retardation, cerebral palsy with severe motor difficulties and recurrence of the disease. Statistically significant correlation existed between poor response to initial treatment and placement in special education, recurrence of disease and cerebral palsy with moderate or severe motor difficulties, the appearence of a different type of epilepsy during follow-up and placement in special education. 18 children (58%) received first treatment with ACTH, 10 (32%) children with IVIG (immunoglobolin iv), 3 (10%) with neither ACTH nor IVIG. Regarding therapy response we found no significant difference between Jews and Bedouins.


CONCLUSIONS
No significant statistical difference was found between the two treatments concerning clinical course or developmental follow-up. Due to small numbers multi-center research is needed.
Vardi
Gideon
G
Zusman Child Development Center, Soroka University Medical Center, Ben Gurion University of the Negev, Beer-Sheva, Israel.
Snapir
Shir Melamed
SM
Merick
Joav
J
Shorer
Zamir
Z
Levy
Jacov
J
Friger
Michael
M
Galil
Aharon
A
D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D018912:Arabs / Q000706:statistics & numerical data*; D002657:Child Development / Q000187:drug effects; D005006:Ethnicity / Q000706:statistics & numerical data*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D015994:Incidence; D007223:Infant; D007557:Israel / Q000453:epidemiology; D007585:Jews / Q000706:statistics & numerical data*; D008297:Male; D012189:Retrospective Studies; D013036:Spasms, Infantile / Q000175:diagnosis* / Q000188:drug therapy / Q000453:epidemiology / Q000209:etiology; D013997:Time Factors
D000927:Anticonvulsants; D000324:Adrenocorticotropic Hormone