Analyses Of Clinical And Aetiology Characters Of Infantile Spasma

Objective: The goal of this retrospective study on the clinical characteristics of infantile spasms is to make early prevention and diagnosis,get reasonable treatment and improve prognosis.Methods: The age and sex distribution, clinical manifestation, EEG, imaging examination and etiology of 87 children which were diagnosed with infantile spasms and admitted into Children's Hospital of Chongqing Medical University from June 2005 to February 2009 were analyzed.Results:(1)In the 87 cases studied, there were 55males and 32 females, the gender ratio (male-to-female) was 1.7:1, their age onset was from 28 days to 21 months, the average age was 6.24±3.2months, born～3 months,～6 months,～9 months,～12 months,～21 months were accounted for 16.1%, 43.7%, 25.3%, 4.6%, 10.3%. The peak onset occurred from 3 months～7 months and 65.5% of the patients were in this age group.(2)Seizure forms: flexor type (73.6%); extensor type (6.9%); mixed type(10.3%); unspecified type(9.2%). 52 children(59.7%) had mental and motor development disorders.(3)Electroencephalogram (EEG) : 9 children(10.3%) had normal EEG (10.3%),78 children(89.7%) had abnormal EEG including hypsarrhythmia(60.2 %), v ariant hypsarrhythmia(23.1% ), other forms of epileptiform discharge (16.7 %).(4) In the 87 cases studied, 41 children accepted CT and CT-positive rate was 59.7%(24/41), 38 children accepted MRI and MRI-positive rate was 71.1%(27/38), 7 children with CT negative finding accepted MRI and 4 children were abnormal,the MRI-positive rate was 71.4%.(5) In the 87 cases studied , 25 cases (28.7%) had cryptogenic IS and 62 cases (71.3%) had symptomatic IS with etiology included brain developmental abnormalities(22),intracranial hemorrhage(3),central nervous system infection(4), HIE(5), tuberous sclerosis(4), intrapartum asphyxia(15), premature children(5), small for gestational age infant(2), trisomy 21 (1), arteriovenous hemangioma(1).Conclusions:(1)The highest incidence was 3 to 7 months in this group. And the incidence of boys was higher than girls.(2) Seizure forms based mainly on flexor type, high percentage of abnormal EEG, especially the hypsarrhythmia EEG.(3) CT and MRI imaging examination was help for etiological diagnosis, MRI examination is better than CT. The positive findings based mainly on abnormal brain development.(4) Children with symptomatic IS were more than cryptogenic IS. Perinatal factors were the main causes for symptomatic IS. Giving an effective intervention can decrease the incidence of IS.