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Archives de pédiatrie
Volume 26, n° 1
pages 1-5 (janvier 2019)
Doi : 10.1016/j.arcped.2018.10.003
Received : 2 September 2017 ;  accepted : 14 October 2018
Research papers

Factors predictive of prognosis of infantile spasms. A retrospective study in a low-income country

R. Ben Abdelaziz a, , b, c , A. Ben Chehida a, b, c, M. Lamouchi a, S. Ben Messaoud a, D. Ali Mohamed d, H. Boudabous a, b, c, M.S. Abdelmoula a, b, c, H. Azzouz a, b, c, N. Tebib a, b, c
a Department of Pediatrics, La Rabta Hospital, Jabbari, 1007 Tunis, Tunisia 
b Université Tunis El Manar, Faculté de Médecine de Tunis, 15, Rue Djebel Lakhdhar, 1007 La Rabta, Tunisia 
c LR12SPO2 les maladies héréditaires du métabolisme investigation et prise en charge, 1007 Tunis, Tunisia 
d Faculty of medicine of Djibouti, Djibouti, Université de Djibouti, Campus de Balbala, Croisement RN2-RN5, BP 1904, 1499 Djibouti, Djibouti 

Corresponding author.

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.

The full text of this article is available in PDF format.

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”.

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