title: Clinical spectrum and treatment outcome of West Syndrome in children from Northern India.
abstract: OBJECTIVE
  This study was intended to document the clinical profile and treatment outcome of West syndrome in children attending a tertiary care center in Northern India.
  
  
  METHODS
  Data were collected by a retrospective chart review of children diagnosed with West syndrome between January 2008 and January 2012. Information was recorded pertaining to the age at onset and presentation, etiology, and associated co-morbidities; results of electroencephalography (EEG) and neuroimaging; treatment given; and final outcome. The following drugs were used for treatment: pyridoxine, prednisolone, vigabatrin, sodium valproate, nitrazepam, topiramate, and levetiracetam. The response was categorized as spasm cessation, partial improvement (>50% improvement), or no improvement. The final outcome was considered favorable when there was a complete cessation of spasms; with absence of relapse and no progression to other seizure types for at least 6 months.
  
  
  RESULTS
  Records of 148 children (120 boys) were analyzed. The mean (SD) age at onset and presentation was 5.3 (4.6) months, and 13.1 (7.3) months, respectively. Perinatal asphyxia (61.4%), neonatal sepsis/meningitis (10.6%), and postnatal meningitis (11.4%) were the predominant causes. The etiology could not be ascertained in 16.6% of children. Favorable outcome was observed in 45 (30.4%) children with spasm cessation rate of 25.4% with prednisolone. Age at onset, gender, time lag to treatment, presence of perinatal asphyxia, or co-morbid cerebral palsy did not affect the final outcome.
  
  
  CONCLUSIONS
  This study highlights the developing country perspective of children with West syndrome, including delayed presentation, adverse perinatal events as the predominant etiology, and modest response to oral steroids.
authors: Department of Pediatrics, Lady Hardinge Medical College and Associated Kalawati Saran Children's Hospital, New Delhi, India.
authors: Jaya Shankar
authors: JS
authors: Kaushik
authors: Bijoy
authors: B
authors: Patra
authors: Suvasini
authors: S
authors: Sharma
authors: Dinesh
authors: D
authors: Yadav
authors: Satinder
authors: S
authors: Aneja
mesh_terms: D000927:Anticonvulsants / Q000627:therapeutic use*; D001921:Brain / Q000503:physiopathology*; D002675:Child, Preschool; D004569:Electroencephalography; D005260:Female; D006801:Humans; D007194:India; D007223:Infant; D008297:Male; D012189:Retrospective Studies; D013036:Spasms, Infantile / Q000175:diagnosis* / Q000188:drug therapy* / Q000503:physiopathology; D016896:Treatment Outcome
chemical_list: D000927:Anticonvulsants
keywords: Epileptic encephalopathy; Hypsarrhythmia; Infantile spasms; Perinatal asphyxia; Symptomatic