title: Long-term outcomes in patients with West syndrome: an outpatient clinical study.
abstract: OBJECTIVE
  Nearly half of all patients with seizure onset in the first year of life suffer from West syndrome (WS). The prognosis of epilepsy and psychosocial outcomes in children with WS are variable. This study was performed to examine the factors influencing the outcome of this patient population.
  
  
  METHODS
  A total of 109 patients with WS followed up regularly for at least 3 years were included in the study. Relevant clinical, laboratory, and imaging data were collected.
  
  
  RESULTS
  The male/female ratio was 65/44 (59.6%/40.4%). The mean age at onset of infantile spasm (IS) was 6 ± 6 (1-36) months. With regard to neuro-developmental and social conditions during the final evaluation, 29.4% of the patients were socially dependent on caregivers, 61.8% needed assistance, and 8.8% were normal. Among the patients, 5.9% were free of epilepsy and antiepileptic drugs (AED) for at least 2 years, 49.0% had no seizures with AEDs, and 45.1% had uncontrollable seizures. Parameters with significant negative effects on the long-term outcomes included symptomatic etiology, presence of developmental retardation before the onset of IS, persistence of active epilepsy, and male gender.
  
  
  CONCLUSIONS
  In this study, 37 (33.9%) patients had severe consequences as a result of WS. The majority of the rest could cope with daily life with varying degrees of assistance. Eight percent of the patients had a normal development. These results draw attention to the two-thirds of patients with WS who have the chance of an acceptable quality of life (QoL) with early diagnosis and therapeutic measures.
authors: Bakirkoy Research and Training Hospital for Psychiatry, Neurology, Neurosurgery, Department of Neurology, Istanbul, Turkey. Electronic address: betultekin2013@gmail.com.
authors: Betül Tekin
authors: BT
authors: Güveli
authors: Haseki Research and Training Hospital, Department of Neurology, Istanbul, Turkey.
authors: Özlem
authors: Ö
authors: Çokar
authors: Fatih Sultan Mehmet Research and Training Hospital, Department of Neurology, Istanbul, Turkey.
authors: Nimet
authors: N
authors: Dörtcan
authors: Istanbul University, Cerrahpasa Faculty of Medicine, Department of Neurology, Pediatric Neurology, Istanbul, Turkey.
authors: Gülçin
authors: G
authors: Benbir
authors: Istanbul University, Cerrahpasa Faculty of Medicine, Department of Neurology, Pediatric Neurology, Istanbul, Turkey.
authors: Veysi
authors: V
authors: Demirbilek
authors: Istanbul University, Cerrahpasa Faculty of Medicine, Department of Neurology, Pediatric Neurology, Istanbul, Turkey.
authors: Ayşın
authors: A
authors: Dervent
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D008297:Male; D010045:Outpatients; D011379:Prognosis; D013036:Spasms, Infantile / Q000175:diagnosis / Q000188:drug therapy / Q000453:epidemiology* / Q000503:physiopathology; D055815:Young Adult
keywords: Epilepsy; Infantile spasm; Prognosis; West syndrome