Neurodevelopmental and epilepsy outcome in children aged one to five years with infantile spasms--a North Indian cohort.
OBJECTIVE
The present study was planned as there is paucity of outcome data of children with infantile spasms, from India where profile of patients is different from the western world. Moreover, most previous studies have either not used strict inclusion criteria or standardized psychometric tests for developmental outcome.


METHODS
Ninety-five children, aged one-to-five years under follow up for more than six months in Pediatric Neurology Clinic of a tertiary care hospital with the diagnosis of infantile spasm were enrolled in this cross-sectional study if they had completed one or more years after the onset of spasms. The study period was January-December 2011. Neurodevelopment of each child was assessed using Development Profile 3 and Gross Motor Function Classification System. History regarding epilepsy frequency and control in the last one year was taken.


RESULTS
Perinatal asphyxia was the commonest etiology in 43/95 children (45.2%). Favorable neurodevelopmental outcome was observed in 8/95 patients. Favorable epilepsy outcome in 58/95 (61.1%) patients was associated with treatment lag≤3 months between apparent onset of spasms and institution of therapy {OR 2 (1.1-3.8)} and response to first line antiepileptic drug {5 (2.6-10)}.


CONCLUSIONS
The commonest etiology was potentially preventable perinatal cause. Early appropriate treatment may have a favorable epilepsy outcome.
Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. Electronic address: sehgal_rachna@hotmail.com.
Rachna
R
Sehgal
Division of Child Neurology, Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. Electronic address: sheffaligulati@gmail.com.
Sheffali
S
Gulati
Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. Electronic address: saprasavita@yahoo.com.
Savita
S
Sapra
Department of Neurology, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. Electronic address: manjari.tripathi@gmail.com.
Manjari
M
Tripathi
Department of Pediatrics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. Electronic address: madhulikakabra@hotmail.com.
Madhulika
M
Kabra
Department of Biostatistics, All India Institute of Medical Sciences, Ansari Nagar, New Delhi, India. Electronic address: rmpandey@yahoo.com.
Ravinder Mohan
RM
Pandey
D000324:Adrenocorticotropic Hormone / Q000627:therapeutic use; D000927:Anticonvulsants / Q000627:therapeutic use; D002675:Child, Preschool; D015331:Cohort Studies; D002658:Developmental Disabilities / Q000175:diagnosis / Q000453:epidemiology / Q000209:etiology; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D008297:Male; D011594:Psychometrics; D012307:Risk Factors; D012720:Severity of Illness Index; D013036:Spasms, Infantile / Q000150:complications / Q000188:drug therapy / Q000453:epidemiology; D018709:Statistics, Nonparametric; D016896:Treatment Outcome
D000927:Anticonvulsants; D000324:Adrenocorticotropic Hormone
Epilepsy; Infantile spasms; Neurodevelopment; Outcomes