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. 2016 Jan-Mar;19(1):52-7.
doi: 10.4103/0972-2327.168627.

The early electroclinical manifestations of infantile spasms: A video EEG study

Mary Iype  1 , Puthuvathra Abdul Mohammed Kunju  1 , Geetha Saradakutty  2 , Devi Mohan  3 , Shahanaz Ahamed Mohammed Khan  2
Affiliations

The early electroclinical manifestations of infantile spasms: A video EEG study

Mary Iype et al. Ann Indian Acad Neurol. 2016 Jan-Mar.

Abstract

Purpose: Infantile spasms are described as flexor extensor and mixed; but more features of their semiology and ictal electroencephalography (EEG) changes are sparse in the literature. The purpose of the study was to describe the clinical and ictal video-EEG characteristics of consecutive cases with infantile spasms and to try to find an association with the etiology.

Materials and methods: The clinical phenomenology and EEG characteristics on video-EEG were analyzed in 16 babies with infantile spasms.

Results: A total of 869 spasms were reviewed. Nine (56.3%) showed focal seizures at least once during the recording and 1 (6.3%) had multifocal myoclonus in addition to the spasms. The duration of the cluster and interval between spasms was totally variable in all patients. Lateralizing phenomena were present in at least some of the spasms in all patients. Unilateral manual automatism in the form of holding the pinna was noted in three patients following the spasm. The ictal EEG activity in the majority (75%) was the slow wave. Four (25%) showed fast generalized spindle-like ictal discharges. Spikes, spike and wave activity, or electrodecremental pattern alone during the ictus was seen in none. On bivariate analysis, no factor noted on the video EEG had association with the etiology.

Conclusion: Infantile spasms could be associated with focal and other seizures, has unique, non-uniform and variable semiology from patient to patient. The ictal EEG manifestation in the majority (75%) of our patients was the slow wave transient with 25% showing generalized fast spindle-like activity.

Keywords: Ictal EEG; infantile spasms; video EEG; west syndrome.

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Conflict of interest statement

Conflicts of Interest: None declared.

Figures

Figure 1
Figure 1
Generalized slow waves corresponding to the spasm and preceded by fast spindle-like activity. Ictal EEG record displayed at 30 mm/s paper speed and 15 microvolt/mm gain
Figure 2
Figure 2
Generalized slow waves corresponding to the spasm, preceded by fast spindle-like activity and followed by voltage suppression. Ictal EEG record displayed at 30 mm/s paper speed and 15 microvolt/mm gain
Figure 3
Figure 3
Fast spindle-like activity corresponding to the spasm. Ictal EEG record displayed at 30 mm/s paper speed and 10 microvolt/mm gain
See this image and copyright information in PMC

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