Abstract
Background: Infantile spasms are an age-specific epileptic disorder. They occur in infancy and early childhood. They can be caused by multiple etiologies. Structural abnormalities represent an important cause of infantile spasms. Brain magnetic resonance imaging (MRI) is one of the integral modalities in the evaluation of this condition. Purpose: The aim of this study is to review and analyze the clinical characteristics and brain MRI findings in a cohort of children diagnosed with infantile spasms. Material and Methods: A cohort of fifty-six children diagnosed with infantile spasms in infancy and early childhood was included. All of them underwent brain MRI for evaluation. The study was conducted in the period from January 2016 to January 2020. Results: Females comprised 57% of the cohort. The mean age for seizure onset was 5.9 months (SD 2.7). Forty-one patients (73%) had active epilepsy, and 51% were diagnosed with global developmental delay. Consanguinity was present in 59% of the cohort. Most of the follow-up MRIs showed structural abnormalities (84%). Hypoxia was reported in 17% of MRIs. Malformations of cortical development were seen in five patients. Brain MRI findings were normal in 16% of patients, and delayed myelination was seen in nineteen patients. Most of the children with active epilepsy (64%) and developmental delay (82%) had an abnormal brain MRI. It was noticed that abnormal second brain MRIs were more likely to be associated with active epilepsy and developmental delay (p = 0.05). Conclusions: Brain MRI is an integral part of infantile spasms’ clinical evaluation. Infantile spasms and abnormal brain MRI can be associated with active epilepsy and global developmental delay.
Highlights
Infantile spasms (IS) are one of the early-onset epilepsy syndromes
Brain magnetic resonance imaging (MRI) findings were normal in 16% of patients, and delayed myelination was seen in nineteen patients
Infantile spasms and abnormal brain MRI can be associated with active epilepsy and global developmental delay
Summary
Infantile spasms (IS) are one of the early-onset epilepsy syndromes. They are characterized by the occurrence of flexion, extension or a mixed cluster of spasms. They can occur up to tens of times per day. Sometimes, they can be associated with sudden crying, eye closure or apnea [1]. They can be associated with sudden crying, eye closure or apnea [1] They occur in infancy before the age of 1 year and, to a lesser extent, in early childhood years.
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