title: The early electroclinical manifestations of infantile spasms: A video EEG study.
abstract: OBJECTIVE
  Infantile spasms are described as flexor extensor and mixed; but more features of their semiology and ictal electroencephalography (EEG) changes are sparse in the literature. The purpose of the study was to describe the clinical and ictal video-EEG characteristics of consecutive cases with infantile spasms and to try to find an association with the etiology.
  
  
  METHODS
  The clinical phenomenology and EEG characteristics on video-EEG were analyzed in 16 babies with infantile spasms.
  
  
  RESULTS
  A total of 869 spasms were reviewed. Nine (56.3%) showed focal seizures at least once during the recording and 1 (6.3%) had multifocal myoclonus in addition to the spasms. The duration of the cluster and interval between spasms was totally variable in all patients. Lateralizing phenomena were present in at least some of the spasms in all patients. Unilateral manual automatism in the form of holding the pinna was noted in three patients following the spasm. The ictal EEG activity in the majority (75%) was the slow wave. Four (25%) showed fast generalized spindle-like ictal discharges. Spikes, spike and wave activity, or electrodecremental pattern alone during the ictus was seen in none. On bivariate analysis, no factor noted on the video EEG had association with the etiology.
  
  
  CONCLUSIONS
  Infantile spasms could be associated with focal and other seizures, has unique, non-uniform and variable semiology from patient to patient. The ictal EEG manifestation in the majority (75%) of our patients was the slow wave transient with 25% showing generalized fast spindle-like activity.
authors.affiliation: Department of Paediatric Neurology, Government Medical College, Trivandrum, Kerala, India.
authors.forename: Mary
authors.initials: M
authors.lastname: Iype
authors.affiliation: Department of Paediatric Neurology, Government Medical College, Trivandrum, Kerala, India.
authors.forename: Puthuvathra Abdul Mohammed
authors.initials: PA
authors.lastname: Kunju
authors.affiliation: Department of Paediatrics, Government Medical College, Trivandrum, Kerala, India.
authors.forename: Geetha
authors.initials: G
authors.lastname: Saradakutty
authors.affiliation: Department of Social and Preventive Medicine, Government Medical College, Trivandrum, Kerala, India.
authors.forename: Devi
authors.initials: D
authors.lastname: Mohan
authors.affiliation: Department of Paediatrics, Government Medical College, Trivandrum, Kerala, India.
authors.forename: Shahanaz Ahamed Mohammed
authors.initials: SA
authors.lastname: Khan
keywords: Ictal EEG; infantile spasms; video EEG; west syndrome