To describe the management of infants with epileptic spasms (ESs) in a low-income country and identify factors predictive of their prognosis.
Material and methods
We conducted a retrospective study in a university hospital in Tunis, Tunisia, over a period of 10 years. We included infants with recurrent ESs.
Thirty-eight patients were included. The median age at onset of ESs was 5 months. Typical hypsarrhythmia was found in 21 patients (55%). Brain MRI was done in 32 patients (84%) and metabolic work-up in 34 patients (89%). ESs were categorized as symptomatic in 58% of the patients. Vigabatrin was prescribed as the first-line drug in almost half of the patients. At the last follow-up, 63% of the patients were seizure-free and 82% had a psychomotor delay. The presence of other types of seizures was associated with uncontrolled epilepsy at the last follow-up (P=0.020). The persistence of spasms after the first-line treatment was associated with abnormal final psychomotor development (P=0.047).
Investigation practices and final outcomes of our patients were comparable to data from high-income countries. Treatment practices have been standardized to be in line with international guidelines.Le texte complet de cet article est disponible en PDF.
Keywords : West syndrome, Epilepsy, Hypsarrhythmia, Prognosis, Tunisia
|☆|| Indication of communication: the preliminary results of this study were partially communicated as posters at the Congress of la Société Française de Pédiatrie in May, 2016, in Lille, France. The two posters were entitled “Apport des examens complémentaires dans le diagnostic des spasmes infantiles” and “Facteurs associés au pronostic neurologique des spasmes infantiles”.
Vol 26 - N° 1P. 1-5 - janvier 2019 Retour au numéro
Bienvenue sur EM-consulte, la référence des professionnels de santé.
L’accès au texte intégral de cet article nécessite un abonnement ou un achat à l’unité.
L'accès au texte intégral de cet article nécessite un abonnement ou un achat à l'unité.