title: Association between infantile spasms and nonaccidental head injury.
abstract: Infantile spasms constitute a severe epileptic encephalopathy of infancy with poor long-term developmental outcome. Many diverse etiologies have been associated with infantile spasms, but the pathophysiological process is still not fully understood. We describe 2 cases of previously healthy 1- and 3-month-old infants who suffered a nonaccidental head injury with extensive cerebral lesions. Both presented with acute focal seizures rapidly controlled with phenobarbital. Nevertheless, they developed infantile spasms after a latency period of 3-4 months. Spasms were rapidly controlled with vigabatrin. Both children manifested with developmental delay, either exacerbated (case 1) or elicited (case 2) by infantile spasms. Our report highlights nonaccidental head injury as a risk factor for developing infantile spasms following a seizure-free latency period. A better understanding of the pathophysiology linking accidental brain trauma with infantile spasms could lead to more effective neuroprotective strategies. In the meantime, increased awareness and follow-up are warranted.
authors.affiliation: 1Department of Neurology, Sainte Justine Hospital (CHU Sainte-Justine), University of Montreal, Montreal, Quebec, Canada.
authors.forename: Ala
authors.initials: A
authors.lastname: Birca
authors.forename: Guy
authors.initials: G
authors.lastname: D'Anjou
authors.forename: Lionel
authors.initials: L
authors.lastname: Carmant
mesh_terms: D006259:Craniocerebral Trauma / Q000150:complications*; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D008297:Male; D013036:Spasms, Infantile / Q000150:complications*
keywords: West syndrome; epilepsy; infantile spasms; nonaccidental head injury; pathophysiology