Abstract
Abstract Aim: Early recognition and initiation of standard therapy are crucial for the management of West syndrome. The study aimed to assess the magnitude, potential determinants, and impact of treatment lag impact on short-term therapeutic outcomes. Materials and Methods: The study design was prospective, observational, and data were ascertained through personal interviews with caregivers and reviewing medical records according to a pre-structured questionnaire. We defined short-term therapeutic response as the cessation of epileptic spasms commencing within 14 days of initiation of hormonal therapy and sustained for ≥28 days. Results: Of 82 consecutively enrolled children with West syndrome, the median treatment lag was 90 days (95% confidence interval [CI]: 110–198 days). The significant determinants of treatment lag in our study were as follows: the preexisting developmental delay, educational status of the parents, and qualification of the first practitioner visited. Our study showed that a shorter treatment lag (<1 month) was associated with a favorable cessation of epileptic spasms (85% vs. 15%; P = 0.011). Conclusion: We observed a significant treatment lag in children with West syndrome. The lead time to treatment emerged as a potentially modifiable risk factor for short-term therapeutic response with hormonal therapy.
Published Version
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