title: Treatment of preterm infants with West syndrome: differences due to etiology.
abstract: BACKGROUND
  This study was conducted with a particular focus on preterm infants with West syndrome (WS) to evaluate differences in the first responses to oral medication based on etiology.
  
  
  METHODS
  Medical records of 53 patients with WS, treated at five institutions between 2005 and 2009, were reviewed retrospectively. Patients were divided into six groups based on the time of brain insult, and evaluated for short-term outcomes using oral anti-epileptic agents and synthetic adrenocorticotropic hormone.
  
  
  RESULTS
  The sample consisted of 15, six, 14, two, four, and 12 patients classified, on the basis of apparent time of acquisition of etiology, into the prenatal, term, preterm, postnatal, other, and no identified etiology groups, respectively. Average age of onset in the term group was 3.3 ± 1.0 months, significantly earlier than in the prenatal, preterm, postnatal and no identified etiology groups (P < 0.05). All patients in the term group had experienced seizures before the onset of WS. Only patients in the preterm group had only experienced neonatal seizures, and responded better to treatment. Patients in the preterm group had better responses to treatment, especially oral medication, compared with those in the prenatal and term groups. The prevalence of relapse of seizures in the preterm group (14%) was significantly lower than that in the prenatal group.
  
  
  CONCLUSIONS
  Preterm WS patients responded well to treatment. Distinguishing WS patients on the basis of different etiologies is important for evaluating the effectiveness of treatment.
authors.affiliation: Department of Pediatrics, Kobe University Graduate School of Medicine, Kobe, Japan. m3u3r9e-1577@iris.eonet.ne.jp
authors.forename: Takeo
authors.initials: T
authors.lastname: Mure
authors.forename: Taku
authors.initials: T
authors.lastname: Nakagawa
authors.forename: Yo
authors.initials: Y
authors.lastname: Okizuka
authors.forename: Yuichi
authors.initials: Y
authors.lastname: Takami
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Oyazato
authors.forename: Hiroaki
authors.initials: H
authors.lastname: Nagase
authors.forename: Azusa
authors.initials: A
authors.lastname: Maruyama
authors.forename: Masao
authors.initials: M
authors.lastname: Adachi
authors.forename: Satoshi
authors.initials: S
authors.lastname: Takada
authors.forename: Masafumi
authors.initials: M
authors.lastname: Matsuo
mesh_terms: D000284:Administration, Oral; D000927:Anticonvulsants / Q000008:administration & dosage / Q000627:therapeutic use*; D004569:Electroencephalography; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000188:drug therapy* / Q000209:etiology; D011247:Pregnancy; D012189:Retrospective Studies; D013036:Spasms, Infantile / Q000188:drug therapy* / Q000209:etiology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants